HAND/UPPER EXTREMITY SURGERY

Toronto Western Hospital
The Hand Surgery Programme is a collaborative effort by the Divisions of Plastic and Orthopaedic Surgery. This is a Canadian fellowship and therefore is NOT accredited by the Accreditation Council for Graduate fMedical Education (ACGME). The ACGME is only responsible for the accreditation of post-MD medical training programmes within the United States. Currently, this is not a paid fellowship. If you have a licence to practice medicine in the province of Ontario, then you would be able to generate income from billing as an Assistant.

Our practice is concentrated in the area of adult hand surgery and includes a broad spectrum of reconstructive problems, hand trauma, arthritis, surgery and peripheral nerve problems. We are also involved in a moderate amount of microsurgical activity and our hospital is the replantation center for Metropolitan Toronto. As such, fellows can gain excellent exposure or experience in microvascular techniques.

Educational Objectives:
At the end of this fellowship, the Fellow will have fulfilled the following educational objectives:

Cognitive

• Demonstrate increased understanding of common and variant anatomy of the hand and upper extremity.
• Demonstrate increased competency in the diagnosis and treatment of common hand conditions and injuries.
• Gain experience in the emergency management of common hand injuries.
• Gain experience in the resuscitation and early management of traumatic hand injuries.
• Understand the principles and management of subspecialty hand surgery which may include replantation, brachial plexus injuries, peripheral nerve injuries, tendon injuries, fractures and reconstructive wrist surgery.

Attitudinal

• Gain experience in approaching and attending to the patient with an upper extremity injury or deformity.
• Gain experience in working with a group of other physicians, nurses and paramedical personnel.
• Learn the value of working in a cohesive, multidisciplinary team setting and appreciate the contributions of each group.

Technical

• Knowledge of surgical exposures in the hand and wrist.
• Knowledge of the use of internal fixation sets specific to care of injuries in the hand and wrist including the mini-fragment and modular hand sets, Herbert and accutrak screws.
• Knowledge of suturing techniques for flexor and extensor tendons
• Knowledge of basic functions of the operating microscope, skill in basic microsurgical procedures like digital nerve repair.

Job Description:

Clinical

• Attend Hand Surgery Outpatient Clinics including that of the primary supervisor and the other members of the Hand Programme.
• Assist in the preoperative assessment, surgery, and postoperative care of the supervisor's and other consultants' patients.
• Assist in the evaluation of consults referred to the supervisor and other consultants.
• Assist in the clinical teaching responsibility of the Division.
• Work with other housestaff members attending patients in the Emergency Department.
• It is clearly understood that none of the above responsibilities will in anyway interfere with the Residency Training Program but will complement the continuous teaching of residents. Fellows will often add an international outlook on teaching.

Research

• Complete a minimum of one clinical or basic science research project and prepare it for presentation and publication.

Application Requirements:

• Letter outlining why you wish to pursue Hand Fellowship training in Toronto
• 2 letters of Recommendation
• Names of 2 additional references that we may contact for information
• Curriculum Vitae
• Proof of TOEFL completion if your language of instruction in medical school was not English

Application Deadline:f
September 1st in the year prior to the proposed start of fellowship. Fellowships begin July 1st annually.

Contact:
Linda T. Dvali, MD, MSc, FRCSC
Hand & Plastic Surgeon, University Hand Programme
University Health Network
2 East - 400, 399 Bathurst St.
Toronto, ON Canada
M5T 2S8
Tel: 416 603-5001
Fax: 416 603-5436
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http://www.surg.med.utoronto.ca/fellowships/ortho/handupperextremity.html