UCLA Campus    |   UCLA Health    |   School of Medicine Translate:
UCLA Health It Begins With U

The UCLA Division of Plastic & Reconstructive Surgery

Print
Email
Share

Hand Surgery Fellowship

Thank you for your interest in our one year ACGME-accredited Hand Surgery-Microsurgery Fellowship at UCLA. The Hand and Microsurgery Fellowship is a combined program within the Department of Orthopaedic Surgery and the Division of Plastic and Reconstructive Surgery.  

While our fellows have the opportunity to interact with residents and attendings from both Plastic Surgery and Orthopedic Surgery, they are primarily supervised in clinic and in the operating room by Prosper Benhaim, MD; Kodi Azari, MD; and Scott Mitchell, MD.  They also have independent clinical responsibilities at all four of our UCLA-affiliated hospitals: West Los Angeles VA Hospital, UCLA Medical Center, Santa Monica; Shriners Hospital, and Olive View County Medical Center. 

Fellows are responsible for providing residents and medical students clinical and didactic instruction, and are encouraged to take advantage of our facilities for microsurgery training and anatomical dissections. We anticipate that one day per week will be blocked off from clinical responsibilities in order to pursue clinical or basic laboratory research. Learn more about fellowship policies »
 

Program Structure:

This is a totally combined service between the Department of Orthopaedic Surgery and the Division of Plastic and Reconstructive Surgery at UCLA. There is no alternating trauma call between orthopaedic surgery and plastic surgery. All bony and soft tissue injuries distal to the wrist go to the Hand Surgery Service. Virtually all distal radius fractures go to the Hand Service, as do a large proportion of both bones forearm fractures. Complex combined injuries of the upper extremity and nerve injuries of the upper extremity also go to the Hand Service. The Hand Surgery Service is frequently consulted for Grade III open fractures of the lower extremity.

The Hand Surgery Service consists of:

  • 4 attendings
  • 2 hand surgery fellows
  • Chief Orthopaedic Resident - PGY5 or 6
  • 6 residents alternating every two months
  • Junior Plastic Surgery Resident - PGY6
  • 4 residents alternating every three months
  • Junior Orthopaedic Resident - PGY2 or 3 alternating every month. The junior orthopaedic resident takes care of all of the minor hand trauma in the Emergency Room, including finger tip injuries and initial reduction of wrist and hand fractures. Patients with more severe hand injuries are initially seen by one of the 2 hand residents, with the hand fellow thereafter involved in the operative treatment or in a consultant role.

 
Fellowship Goals:

The UCLA hand fellowship is completely integrated between orthopaedic surgery and plastic surgery. There are very few such integrated fellowships in the United States. The fellowship program stresses mentorship, with "one-on-one" relationships between the fellow and faculty. This is in contrast to fellowships where a fellow only spends 1 or 2 months with 6 attendings and does not get to understand the thinking and judgment of an attending. The fellow spends three months with Dr. Meals and then three months with Dr. Benhaim on a repeating cycle, for a total of six months on each of the two services. The attending physicians are effective and patient teachers with numerous awards for their teaching acumen. The attending will take the fellow through surgical procedures, rather than having the fellow "hold hooks", or "reinvent the wheel" at the other extreme. The full spectrum of hand surgery is seen at UCLA, fellows typically don't see too much of the same conditions and nothing is really missed. Fellows will see a wide variety of trauma, post-traumatic reconstruction, distal radius fractures, and wrist pain, both rheumatoid and congenital. The UCLA fellowship is particularly strong in microsurgery with a good volume of peripheral nerve surgery, and free flap and toe transfer reconstructions of the upper extremity. There is excellent exposure to extremity salvage reconstruction after malignant tumor resections (Dr. Eckardt) and toe transfers for congenital hand reconstruction.

Learn more about the fellowship goals and objectives »

 
Application Deadline and Process:

Please contact the Orthopaedic Surgery Education Office for current information on the Hand Fellowship position.
orthoeducation@mednet.ucla.edu

Thank you again for your interest in the UCLA Hand and Microsurgery Fellowship. We encourage you to remain in touch with the Fellowship Coordinator regarding the status of your application.

We accept the Universal Hand Surgery Fellowship application. Complete and return the application and waiver form, along with a photo, brief personal statement and a copy of your CV.  Please arrange to have three letters of recommendation forwarded, one from the chief of your residency training program and one from the hand surgeon who knows you best.

UCLA participates in the NRMP Hand Fellowship Specialty Match and you should contact the NRMP for an applicant agreement for the Hand Surgery Specialty Match. Applicants should have completed a residency in orthopaedic surgery, plastic and reconstructive surgery or general surgery. A California license is a requisite for the incoming fellow.

Please submit your application and letters of recommendation to the Department of Orthopaedic Surgery Education Office at the location listed below. After review of the applications, applicants will be invited to Los Angeles, usually in late February-March, for a mutual visit and interview.

Independent Responsibility:

The UCLA fellowship does expect that each individual fellow will gain progressive confidence over the course of the fellowship in transitioning from fellow to independent surgeon, yet with the assurance that attending staff is available at all times for supervision and mentoring. Our goal is that the fellows will learn the critical nuances from the attending staff that will allow him or her to become a highly competent and independent hand surgeon. In conjunction with the attending staff, the fellow is expected to be actively involved in teaching both orthopaedic residents and plastic surgery residents the wide spectrum of hand surgery during both emergency and elective hand surgery.
Research

Each fellow is expected to complete two research projects, one of which is usually presented at the annual UCLA Orthopaedic Residents Day, but ultimately should be presented at a national meeting and published if possible. Fellows have usually become involved in clinical projects but there are multiple opportunities for projects in basic science. Previous research includes Gordon Singer, M.D., who completed a biomechanical study of flexor tendon repairs and Ranjan Gupta, M.D., who studied nerve compression. The Sumner Koch prize for the best research paper at the annual meeting of the American Society for Surgery of the Hand has been won by a UCLA fellow or resident four times out of the last ten years. 

  • Microsurgery Lab in plastic surgery
  • Bio-mechanics Lab staffed by a full-time PhD biomechanical engineer
  • Fresh cadaver dissections in the anatomy department
  • Basic research: Dr. Benhaim has directed a basic science lab with a major emphasis on tissue engineering of cartilage and bone. A number of labs at UCLA have focused on tissue engineering with musculoskeletal emphasis.


Salary, Vacation and Meetings:

The fellows are paid at the relevant PGY 6, 7, 8 or 9 level which is approximately $50,000. per year. Travel and accommodation expenses are paid for one meeting per year, which is usually the American Society for Surgery of the Hand meeting in the fall. Each fellow receives one month of paid vacation.
 

Training Institutions:

Ronald Reagan UCLA Medical Center
The majority of the fellowship is based at Ronald Reagan UCLA Medical Center. The fellows will be exposed to traumatic and elective hand surgery, as well as attending the private offices of Drs. Benhaim and Meals. UCLA is one of four Level 1 Trauma Centers in Los Angeles County and one of two University Hospitals (the other being USC-LA County). RRUCLA is a new, state-of-the-art facility that integrates a large number of technical advances that facilitate the delivery of healthcare and maximize patient/family comfort.

Olive View-UCLA Medical Center
One of the fellows will attend hand clinics on alternating Thursday. The clinic sees approximately 70-100 patients per clinic. The fellow will participate in the elective hand surgeries on Thursdays between clinics. There is a high volume of straightforward hand trauma seen through the Olive View Emergency Room --primarily wrist fractures, hand fractures, tendon lacerations, and nerve injuries. There is only one plastic surgery resident at Olive View and the fellows act as an attending hand surgeon on an alternate weekly call. However, this is not an onerous call schedule and the fellows rarely have to go out to Olive View at night. The patient population at Olive View is interesting in that they come from virtually every country in the world looking for their "piece of the American dream." Consequently, they are motivated to return to work and are generally very grateful for their hand surgery.

West Los Angeles VA Hospital
This is not really a fellowship rotation and is primarily for the two hand surgery residents. However, the fellow may occasionally cover the Friday VA hand clinic or the Monday hand surgery operating session if the hand residents are away or if the attending is away.

UCLA Medical Center, Santa Monica and Orthopaedic Hospital
This is a private hospital in Santa Monica that was taken over by UCLA and has become a second campus for the RRUCLA Medical Center. There is no primary call obligation at Santa Monica, with all significant hand trauma either stabilized and referred to an outpatient clinic, or transferred to RRUCLA in Westwood for urgent inpatient care.

Shriners Hospital - Los Angeles
One fellow will accompany Dr. Jones to a monthly congenital hand clinic at Shriners Hospital on the second Tuesday of the month. Both fellows will gain experience in microsurgical reconstruction of congenital hand anomalies, such as toe transfers, approximately once a month. There is also the opportunity to perform approximately 6 pollicization procedures per year with John Lawrence, MD.
 

Educational Program:

Weekly Hand Conference
On Tuesday afternoons, either a resident or fellow will give a 30-45 minute didactic talk, followed by a lively discussion generated by the attendings. At the second Tuesday of the month hand conference, the two fellows show all the interesting cases from the previous month, which also acts as an audit of cases preformed by the fellows in their attending role. This is probably the most informative conference and the fellows present slides or digital photographs and relevant x-rays of all cases. This photographic documentation allows teaching at all levels from the medical student level through the orthopaedic and plastic surgery residents, up to the fellow and attending level.

Monthly Journal Club
Held at the home of Dr. Roy Meals, this is attended by the UCLA attendings, as well as several of the community hand surgeons. Interesting or complicated cases are routinely presented, followed by review of 8-10 articles per month from the Journal of Hand Surgery or other appropriate journals. This has proven to be a valuable format for both social interaction and informal learning.

Orthopaedic Surgery Core Curriculum
Presented Wednesday mornings from 6:45 AM to 8:15 AM, two lectures per week for 8 weeks are given on basic hand surgery topics to the orthopaedic surgery residents and usually each fellow will give two of these lectures. This 8 week series of lectures takes place on a two-year cycle.

Hand Dissections
Each fellow and each resident on the service in July will demonstrate hand and upper extremity anatomy to all the orthopaedic surgery and plastic surgery residents during one or two sessions.

Basic Microsurgical Lab Course
This weeklong program is for an incoming orthopaedic-trained fellow. We usually arrange for such a fellow to spend one week in the microsurgery lab during the first month of the fellowship in August to hone his or her microsurgical skills. However, we would also prefer any incoming orthopaedic-trained fellow to have completed a one-week basic microsurgery course at his or her home institution prior to the fellowship. Similarly, we would prefer to have any plastic surgery-trained fellow complete a basic AO internal fixation course prior to beginning the fellowship.
 

Contact Information:

Orthopaedic Surgery Education Office
David Geffen School of Medicine at UCLA
Room 76-143 CHS
10833 Le Conte Avenue
Los Angeles, CA 90095

Tel: (310) 825-6557
Fax: (310) 825-1311
email: orthoeducation@mednet.ucla.edu

 

UCLA Rated One of the Top Hospitals in the Nation