Plastic Surgery

Hand Surgery Fellowship

Fellowship Goal

The goal of the ACGME-accredited UT Southwestern Hand Surgery Fellowship is to prepare individuals for a successful career in hand surgery. The Fellowship Program provides in-depth and comprehensive training in all areas of adult and pediatric hand and wrist surgery. In addition, hand surgery fellows are able to develop and hone leadership, education, and research skills.

surgeon Dr. Jennifer Kargel performs operation on ganglion cyst
Dr. Jennifer Kargel (right) excises a ganglion cyst.

Faculty

surgeon Dr. Daniel Koehler performs operation on hand
Dr. Daniel Koehler (center) teaches an LRTI.

The Hand Surgery Fellowship is a cooperative effort that includes the Departments of Plastic Surgery and Orthopedic Surgery. Our faculty include:

Jonathan Cheng, M.D. plastic surgery

Ann Golden, M.D. orthopedic surgery

Jennifer Kargel, M.D. plastic surgery

Daniel Koehler, M.D. orthopedic surgery

Shelby Lies, M.D. plastic surgery

Andrei Odobescu, M.D., Ph.D. plastic surgery

Scott Oishi, M.D. plastic surgery

Richard Samade, M.D., Ph.D. orthopedic surgery

Douglas Sammer, M.D. plastic surgery, fellowship program director

Christopher Stutz, M.D. orthopedic surgery

Andrew Zhang, M.D. plastic surgery

Institutions

Hand surgery fellows rotate through multiple institutions, including UT Southwestern University Hospitals, Parkland Hospital, Children’s Health℠, the Dallas Veterans Affairs Medical Center, and Scottish Rite for Children. Each institution has unique characteristics and patient populations that expose the hand surgery fellows to a wide range of hand and wrist problems.

Education

There are two hand-focused didactic sessions each week:

Hand Indications Conference

On Tuesdays at Hand Indications Conference, we hold a case-based discussion of interesting cases that are scheduled for the upcoming week.

  • Tuesday, 6 a.m.-7a.m.

  • Case-based

Hand Conference

The formal Hand Conference is held on Thursdays, and is a traditional teaching conference. The curriculum begins with straight-forward topics and addresses increasingly complex issues over the course of the year. While there are learners of all levels present in Hand Conference, these sessions are focused on fellow-level education. Most lecture topics are presented by experienced hand surgery faculty, with a few sessions over the course of the year being presented by the hand fellows. In addition, intermixed with the clinical topics are three to four sessions dedicated to "the business of hand surgery," presented by various community surgeons. Quarterly M&M and journal review are also incorporated into the Hand Conference curriculum.

  • Thursday, 6 a.m.-7a.m.

  • Didactics, journal review, M&M, business of hand surgery

Clinical Exposure

surgeon Dr. Douglas Sammer performs operation on hand
Dr. Douglas Sammer (left) performs endoscopic CTR.

The diversity of institutions allows hand surgery fellows to be exposed to an array of complex hand and wrist problems over the course of the Hand Surgery Fellowship Program, including:

  • Reconstruction of the hand, wrist, and forearm
  • Degenerative and autoimmune diseases
  • Acute and non-acute trauma, including hand, wrist, brachial plexus, and replantation
  • Arthroscopy of the hand and wrist
  • Congenital hand and upper extremity, pediatric brachial plexus, and cerebral palsy
  • Arthroplasty in the hand and wrist
  • Fellows who have an interest in shoulder and elbow surgery are able to receive some exposure in those areas, although the true focus of the fellowship is hand and wrist surgery.

Case Volume

The Hand Fellows each perform approximately 750 cases per year. The weekly case load per fellow is about 12 to 20 cases. In the table below, we have selected a few case types and the corresponding single-fellow volume from a recent academic year to give a representative idea of the clinical exposure.

Rotation Schedule

The Hand Fellows alternate between two main rotations, the Parkland Memorial Hospital (PMH) rotation, and the UT Southwestern/Children's/VA (UT/CMC/VA) rotation. These rotations last three months each, allowing the fellow to become fully integrated into the hand surgery team at each location. On each rotation, the fellow will spend approximately equal time working with orthopedic and plastic hand surgery faculty. Each fellow rotates onto these two services twice over the course of the year. In addition, near the end of the academic year, each fellow will spend six weeks at Texas Scottish Rite hospital in Dallas on a dedicated congenital hand surgery rotation.

Call Schedule

The Hand Fellows typically take call one week at a time, alternating weeks between the two fellows. There is always a team of senior and junior residents on call in front of the hand fellow. The Hand Fellow is only called for cases that go to the operating room. Past fellows have found this arrangement to be highly educational and minimally burdensome.