Some commentary on the "Hand Surgery" remarks:
As part of our residency training in our third year we spend 2 months with a well known Harvard-trained hand surgeon who operates on adults and pediatrics taking primary hand trauma call at HUP(Hosp of the University of PA) and CHOP(Children's Hosp of Philadelphia). He is a plastic surgeon by training with a ortho/hand fellowship and we are primary assist on all his cases so we get to do a lot of hand/forearm cases. HOWEVER, I would never attempt to operate on any hands in the private sector. Your malpractice will not cover you, your state association will not protect you, and you are not practicing under an acceptable standard of care. I am very aggressive surgically but you need to know your limitations. The more you learn/advance, the more you realize what you can do safely. If you can rotate with a hand service this will greatly help your hand skills especially if you have/use loupes and they allow you to do microsurgical procedures with them. This will give you a new respect for this difficult skill. I feel if you have a question whether you should be performing a procedure or not, ask yourself the question, "Am I prepared to deal with ALL complications from this procedure?" This also relates to a more podiatric question - If you aren't prepared to treat tibial fractures, should you be doing supramalleolar ostetomies or harvesting bone graft from the tibia? Just my perspective.
