Hand Surgery through Ortho or General?

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Sep 4, 2004
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Everyone always talks about orthos doing hand/wrist surgery but it is listed as a subspecialty of general surgery.. can anyone set me straight? How competitive is it to get into this subspecialty?

dry dre

All hat, no cattle
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15+ Year Member
Dec 20, 2003
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Yes, you can do a hand fellowship after general surgery.

If you use a FREIDA search of "ortho" hand fellowship programs and read the web pages some/many of the programs you will see that the requirement to enter the fellowship often includes board eligibility in general surgery, not just ortho/plastics. If you look at the fellow profiles, you'll see general surgery guys mixed in all over the place.

At the same time, in a recent ortho conference, there was mention that hand fellowhips are going to have to incorporate more upper extremity into the training programs; I don't know how this would effect general/plastics guys, at least in ortho-based programs (whatever that means). From an ortho perspective, hand isn't the most popular area to specialize in.

Generally speaking, if you want to do a hand fellowship from general, you will probably get in somewhere. It certainly wouldn't hurt to do some hand research in residency and would certainly be necessary to hit the ground running in fellowship (ortho residency includes a lot of hand education and experience). Hand mechanics gets very difficult real quick...

Winged Scapula

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Apr 9, 2000
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Echoing dry dre's response...

the fellowships are not very competitive, but be aware that some ONLY take Ortho or PRS trained fellows.

the ease of getting a Hand fellowship does not mean that you will find work easily. Having once been interested in the field, my research found that general surgeons without additional PRS or Ortho training would have a difficult time making a living doing only hand, in most metro areas. Reasons:

a) Ortho groups don't want to hire you because you can ONLY take hand call, no general Ortho call

b) PRS groups don't want you because you can't take general plastics call

c) general surgery groups are loathe to cover your hand patients when you are out of town, and would want you to take gen surg call.

Remote areas you might find enough work to keep yourself busy, but the professional and economic impact of only doing hand as a general surgery trained resident should not be ignored.