University of California (San Francisco) Program

The UCSF Hand, Elbow, and Upper Extremity Fellowship Program is designed to provide advanced training in hand and microvascular surgery through a unique collaboration between the UCSF Department of Orthopaedic Surgery and the UCSF Division of Plastic and Reconstructive Surgery. This fellowship offers a comprehensive clinical experience across different campuses of the UCSF School of Medicine, including UCSF Moffitt Long Hospital, Zuckerberg San Francisco General Hospital, and UCSF Mission Bay Children’s Hospital 1.

As part of the fellowship, participants will engage in a longitudinal ambulatory clinic experience at the Orthopaedic Institute at Mission Bay, allowing for continuity in patient care and exposure to a variety of cases 1. The program emphasizes a one-on-one apprenticeship model whereby fellows work closely with attending physicians, fostering an environment focused on mentorship and hands-on learning.1

Throughout the fellowship year, the clinical responsibilities are designed to enhance the skills of fellows progressively, starting with assisting attending surgeons in the operating room and evolving into junior attending roles, where they will supervise residents. The program aims for fellows to achieve independence and the necessary skills to excel in their careers by the conclusion of the fellowship 1.

Curriculum Structure

The curriculum is structured to provide an optimal blend of accountability and flexibility. The first half of the fellowship year consists of a structured rotation, while the latter half allows for the exploration of personalized learning avenues based on individual goals and interests. This balance enables fellows to maximize exposure to specialty areas relevant to their career aspirations 1.

Weekly Schedule

The weekly schedule includes:

• Monday: 6:45 am - Hand conference at Orthopaedic Institute (OI); 8 am - 5 pm - Longitudinal Ambulatory clinic at OI.
• Tuesday: 7:30 am - 5 pm - Ambulatory Surgery center at OI.
• Wednesday: 7:30 am - 5 pm - Surgery at Alta Bates Surgery Center or ZSFG OR.
• Thursday: 7:30 am - 5 pm - Surgery at UCSF Moffitt Long Hospital/Parnassus or OI/Mission Bay.
• Friday: Cadaver dissections, interdisciplinary clinics, and research activities 1.

Research Opportunities

The research component of the fellowship benefits from UCSF's integrated multidisciplinary research laboratory, which includes various resources like the Orthopaedic Biomechanics Laboratory and a 3D printing laboratory. Fellows are encouraged to engage in basic science projects concentrating on wrist and hand biomechanics, soft tissue repair, and imaging studies. Research is structured to nurture essential research methodology skills, ensuring that all fellows complete a project by the end of their year, with opportunities for publication and presentation at national meetings 1.

Conferences and Educational Experiences

As part of their professional development, fellows are encouraged to participate in a plethora of organized conferences and rounds, including:

• Hand Service conference (Monday)
• Zuckerberg San Francisco General hospital Hand conference (Tuesday)
• UCSF Orthopaedic Grand Rounds (Wednesday)
• Various journal clubs and indication conferences 1.

Application Process

The program currently only accepts one fellowship position and does not consider foreign applicants, making it relatively competitive. Applicants must submit a completed Universal Hand Application along with a current curriculum vitae, personal statement, USMLE board scores, medical school transcripts, and three letters of recommendation. The application process includes a virtual interview 1.

Visa Support

The program does not currently accept international medical graduates; thus, visa sponsorship is not applicable. However, for U.S. citizens and permanent residents, the program offers a supportive and rigorous training environment ideal for their professional development 1.

Conclusion

Overall, the UCSF Hand, Elbow, and Upper Extremity Fellowship Program is tailored for those seeking intensive training and experience in the field of hand and microvascular surgery. It combines clinical practice, innovative research, and individualized learning pathways to prepare fellows for a successful career.