Hand fellowship from G.S.?

[CyrusHabs7695]

Cannot seem to find any data or another thread on the topic, so I figured I'd ask and see if anybody knows.

How attainable is a hand surgery fellowship out of a general surgery residency? Is there a higher preference for Ortho and Plastic residents?

I'm assuming post-fellowship, a person who went the general surgery route would receive the same responsibilities and pay as a person who went the ortho/plastics route?

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[LucidSplash]

Old thread bumped and added to about a year ago: Hand Surgery fellowship after General Surgery.

 

[CyrusHabs7695]

Old thread bumped and added to about a year ago: Hand Surgery fellowship after General Surgery.

So what I got out of that is its possible to get in the fellowship, but getting a job is a different story?

 

[LucidSplash]

So what I got out of that is its possible to get in the fellowship, but getting a job is a different story?

My takeaway from the thread is that getting a fellowship is technically possible but an uphill battle all around, getting a job is probably even worse.

 

[CyrusHabs7695]

My takeaway from the thread is that getting a fellowship is technically possible but an uphill battle all around, getting a job is probably even worse.

I find it odd that they even have the hand fellowships open to GS residents if its difficult for them to obtain jobs.

 

[LucidSplash]

I find it odd that they even have the hand fellowships open to GS residents if its difficult for them to obtain jobs.

If you read the thread carefully you'll see that GS-->hand is basically of historic interest only. Most places screen applicants and don't take them. There USED to be a pathway, and while it still technically exists on paper, it is going the way of the dodo. It is not yet totally extinct but it is on the watchlist and is "near extinct."

 

[TypeADissection]

I thought there were a lot of good hand jobs out there...

Hold on. Let me rephrase that.

 

[vhawk]

If you read the thread carefully you'll see that GS-->hand is basically of historic interest only. Most places screen applicants and don't take them. There USED to be a pathway, and while it still technically exists on paper, it is going the way of the dodo. It is not yet totally extinct but it is on the watchlist and is "near extinct."

This maps with my experience, had a residency mate who was interested in doing a hand fellowship, wanted to do the fellowship at our place of gen surg residency/home institution, was well-known and well-liked by the chief of plastics who directed the hand fellowship, was at least an ok candidate on paper....and he was basically told no, for the reasons above. He was even planning on practicing in a very rural area in which the skills from a hand fellowship would actually come in handy (rimshot) but still no dice.

 

[sinombre]

My takeaway from the thread is that getting a fellowship is technically possible but an uphill battle all around, getting a job is probably even worse.

I don’t have any interest in this pathway, but any idea of why this is the case? I’m kind of surprised to hear that getting a job would be difficult after a fellowship.

 

[CyrusHabs7695]

maybe @OrthoTraumaMD could add some info, being an orthopaedic

 

[LucidSplash]

I don’t have any interest in this pathway, but any idea of why this is the case? I’m kind of surprised to hear that getting a job would be difficult after a fellowship.

I’m not sure why people keep asking questions that are already answered from that other thread but sure.

Again, my takeaway from the other thread is that since most of these jobs are with ortho or PRS groups, and GS-trained hand surgeons don’t have an otherwise overlapping skill set to take non-hand ortho or PRS call coverage, so they aren’t particularly competitive job candidates.

 

[Pir8DeacDoc]

The corollary in my specialty is head and neck cancer surgey. General surgeons are candidates for that fellowship. But you can't really be part of an ent group if you can't take call. So not that interesting of a candidate for employment

 

[Winged Scapula]

I’m not sure why people keep asking questions that are already answered from that other thread but sure.

Again, my takeaway from the other thread is that since most of these jobs are with ortho or PRS groups, and GS-trained hand surgeons don’t have an otherwise overlapping skill set to take non-hand ortho or PRS call coverage, so they aren’t particularly competitive job candidates.

Yep, that's it.

I have a friend who did GS ---> Hand fellowship (he failed to match Ortho so settled for GS). The problem he says is that he's not really happy in his current job (mostly because his wife would like to live in another area of the country) but that he fears that if he leaves, he won't find another job. So he does his best to do his job well, get along well with everyone because he feels like he can't afford to piss anyone off, its that bad.

 

[ram006]

I did my ortho rotation as a medical student and was fairly convinced I was going to do either joints or hand. For personal reasons, I was geographically restricted to one town with one GS program and one Ortho program. Didn't get an invite for Ortho so I ranked one GS program. At the time, I was under the impression that Hand was a legitimate fellowship option. It is not. Ya, you might be the one person in the match that gets a spot, but being employable is another issue.

During residency, I actually approached the fellowship director at my home institute about applying after GS and was flat out told he would never consider a GS resident because the experience is either non-existent or too inconsistent between programs to pass on an Ortho or Plastics resident who he knows has gotten a substantial experience. I matched into an independent plastic surgery spot and am applying to hand fellowships this year.

Its a tough pill to swallow, but you should either consider something else or make yourself a competitive applicant by doing three years of plastic surgery and applying for a fellowship.

I've started to put my feelers out for possible jobs and the experience thus far has only affirmed my choice. I plan on doing hand/wrist and going as proximal as I can go but will be competing with Orthopods and most certainly will need to do general plastics/micro/breast recon to be of any value. Thats why the programs I'm applying to have "hand, upper extremity and microsurgery" in their description. As long as my diploma/certificate says those things I can advertise being fellowship trained in all those facets.

No one cares that I can take out a gallbladder. Literally no one. No one even cares if I'm boarded in general surgery. It's of really no value other than a talking point...

Pursuing hand after gen surg/plastics was the right choice for me, but I am certainly not under the impression it is for everyone. I see a lot of my residency classmates living that attending life on the 'gram...

 

[sinombre]

I’m not sure why people keep asking questions that are already answered from that other thread but sure.

Again, my takeaway from the other thread is that since most of these jobs are with ortho or PRS groups, and GS-trained hand surgeons don’t have an otherwise overlapping skill set to take non-hand ortho or PRS call coverage, so they aren’t particularly competitive job candidates.

My bad. Probably should have read through the other thread before responding.

 

[OrthoTraumaMD]

I’m not sure why people keep asking questions that are already answered from that other thread but sure.

Again, my takeaway from the other thread is that since most of these jobs are with ortho or PRS groups, and GS-trained hand surgeons don’t have an otherwise overlapping skill set to take non-hand ortho or PRS call coverage, so they aren’t particularly competitive job candidates.

Yep that’s it.



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[VincentAdultman]

Going into hand from general surgery would just be an exercise in torture for both you and your hand mentors. It's like learning an entirely different skillset compared to what you did for the last 5 years save the couple months you may have done on a plastics rotation.

This is what I said in the last thread.

In addition to coverage issues when you're in practice, you're going to go into fellowship lacking basic skills that all ortho residents learn by their second year. You wont be able to do a good physical exam or interpret plain films or MRIs. I would also think that a hand fellow would be able to do simple hand cases (carpal tunnels, trigger releases, pinning of some fractures) that Im not sure a fellow with no ortho training would do. I mean I GUESS you learn some of that during a 2-3 month elective? I cant imagine how comprehensive that is though.

 

[Lawpy]

This is what I said in the last thread.

In addition to coverage issues when you're in practice, you're going to go into fellowship lacking basic skills that all ortho residents learn by their second year. You wont be able to do a good physical exam or interpret plain films or MRIs. I would also think that a hand fellow would be able to do simple hand cases (carpal tunnels, trigger releases, pinning of some fractures) that Im not sure a fellow with no ortho training would do. I mean I GUESS you learn some of that during a 2-3 month elective? I cant imagine how comprehensive that is though.

That's what I thought so I was surprised that general surgery --> hand fellowship actually existed in the first place.

 

[lagbydesign]

That's what I thought so I was surprised that general surgery --> hand fellowship actually existed in the first place.

It's because, if I remember correctly, hand originally was a subspecialty of gen surg. Like, a general surgeon started the specialty.

 

[vhawk]

It's because, if I remember correctly, hand originally was a subspecialty of gen surg. Like, a general surgeon started the specialty.

Most subspecialties were

Cushing was trained by halsted, etc