A Message from the Program Directors

Transcript

• 00:05Hello, I'm Grant Thompson,
• 00:06the director of the combined hand and Upper
• 00:09Extremity Fellowship at Yale University.
• 00:11In this short video, I hope to give
• 00:13you a sense of the history and future
• 00:15of hand education at our institution.
• 00:18I'm standing in front of
• 00:19Sterling Hall of Medicine,
• 00:20the main campus of medical school.
• 00:22The school was founded in 1810 and opened
• 00:25in a building about a mile from here.
• 00:28They moved to this building in
• 00:291925 to be close to the hospital.
• 00:32State hospital,
• 00:32as it was known at the time,
• 00:34was built on this site almost
• 00:36100 years earlier in 1833,
• 00:38on 7 1/2 acres of land.
• 00:40The original 13 bed hospital cost $13,000,
• 00:44roughly equivalent to $380,000 today,
• 00:47accounting for inflation. During
• 00:49the Civil War, the US
• 00:50government leased the hospital
• 00:52for $1000 a year,
• 00:53and it was temporarily renamed the
• 00:55Knight United States Army Hospital
• 00:57in honor of Jonathan Knight,
• 00:59one of the original founders.
• 01:01Tents were erected.
• 01:02On the grounds to accommodate
• 01:04more than 1500 beds.
• 01:05Regular hospital activities
• 01:06were moved to rented
• 01:08quarters about a mile away. Yale New Haven
• 01:10has been on alert as a
• 01:12designated military hospital
• 01:13in every subsequent war.
• 01:14In 1870, the east and
• 01:17West wings were added on either
• 01:18side of the main building to add
• 01:21126 more beds for patients and a
• 01:23dormitory for the new Connecticut
• 01:24Training School for nurses.
• 01:26In 1884, the hospital's name was
• 01:28changed to New Haven Hospital,
• 01:31seen here in a photo from 1911 Yale School
• 01:34of Medicine and New Haven Hospital.
• 01:35Formalize their relationship in 1913.
• 01:39We can still see the original building. Let's
• 01:41go take a look.
• 01:43Walk along this hallway every
• 01:44day on my way to work, along
• 01:46with hundreds of other people.
• 01:48The inscription above the
• 01:50pillar says 1826 on the left,
• 01:52then New Haven Hospital and
• 01:541930 on the right.
• 01:56So obviously this facade,
• 01:57or maybe the whole building,
• 01:58has been modified about 100 years
• 02:00after it was first built.
• 02:02Unfortunately, there have been
• 02:03many more additions to the
• 02:04old structure over the years,
• 02:05and they have basically enclosed it so
• 02:07it's not visible from the street any
• 02:09longer. In this flyover you can
• 02:11see the relationship between
• 02:12the new hospital and the left.
• 02:14The old hospital here and the
• 02:16medical school behind it.
• 02:19The hospital moved across the street in
• 02:211953, but the buildings associated with
• 02:23the original hospital were still used for
• 02:26lab testing and outpatient facilities.
• 02:28Today, they're mostly academic offices
• 02:31and research laboratories. York
• 02:33Street campus of Yale, New Haven Hospital
• 02:35is just a short walk from our academic
• 02:38offices and from the medical school.
• 02:42The inpatient buildings of Yale
• 02:44New Haven Hospital include four
• 02:46pavilions around a central atrium.
• 02:48The building here is the East
• 02:50pavilion, opened in 1953.
• 02:53The South pavilion in 1982.
• 02:56The Children's Hospital in 1993.
• 03:02And Smilo Cancer Center in 2009.
• 03:05Together, these four pavilions
• 03:07make up the York Street campus,
• 03:10which has a total of 15141 inpatient beds.
• 03:15Short shuttle bus ride away from York
• 03:17Street campus is Saint Rayfield campus,
• 03:20which has 300 inpatient beds,
• 03:22but important to us it is the
• 03:24location of the Mcgibney
• 03:26Advanced Surgery Center,
• 03:27designed specifically
• 03:28for ambulatory musculoskeletal care.
• 03:33September 2018. It features six
• 03:35large operating rooms and prioritizes
• 03:37patient comfort and efficiency
• 03:38in all aspects of patient care.
• 03:43Yellow Haven Health system is
• 03:45now the largest in Connecticut.
• 03:46And it's not just Yale New
• 03:48Haven Hospital anymore.
• 03:49The system includes hospitals,
• 03:51physicians and related health
• 03:53services throughout Connecticut as
• 03:54well as New York and Rhode Island.
• 03:56Fun fact, did you know that the
• 03:58first X-ray produced in the US
• 04:00was a human even hospital in
• 04:021896? Second fun fact, did you know
• 04:05that chemotherapy was invented
• 04:07by a surgeon and it was first used to
• 04:09treat cancer and neonate and hospital in
• 04:121942? The history of cancer surgery
• 04:14at Yale dates to 1971, just prior
• 04:17to the first plastic surgery
• 04:19resident Stephen Arian, who became
• 04:20one of only four chiefs of
• 04:23plastic surgery. The Hand
• 04:24Fellowship was established in 1997 and
• 04:26was expanded to two fellows starting in
• 04:292021. Fellowship training is
• 04:31integrated between the division
• 04:32of Plastic Surgery and the Department
• 04:34of Orthopedics, and Fellows
• 04:36split their time between the two
• 04:37disciplines. A rigorous clinical
• 04:39and academic experience provides
• 04:41education in the full spectrum of hand.
• 04:44And not perform any surgery.
• 04:47There is full support from
• 04:48leadership in the departments
• 04:49of Surgery and orthopedics.
• 04:51The ortho chair doctor Lisa Latanza is
• 04:53also faculty in the Hand Fellowship.
• 04:55Other faculty includes the fellowship
• 04:57program directors and the other
• 04:59full-time faculty seen here.
• 05:02Combining this experience with
• 05:03contributions from the part time
• 05:05faculty, there is an abundance
• 05:07of opportunity for clinical and
• 05:08academic activity for both fellows.
• 05:11All of the faculty on the plastic surgery
• 05:13side of the fellowship are skilled
• 05:15in all aspects of hand and. Surgery,
• 05:18including microvascular reconstruction.
• 05:19Some of the plastic surgery faculty
• 05:23have specialized interests
• 05:24such as brachial plexus and
• 05:25peripheral nerve reconstruction
• 05:27or pediatric cancer surgery.
• 05:30And now a few words from our
• 05:32associate program director.
• 05:33Hi, I'm Doctor Andrew haleem.
• 05:36I'm an orthopedic trained hand
• 05:37surgeon and I'm proud to be the
• 05:39associate fellowship director for
• 05:41Yale Combined Hand Fellowship.
• 05:42I'm here today to tell you a little
• 05:44bit about the orthopedic side of
• 05:45our hand fellowship and to get
• 05:46you excited about coming to train
• 05:48with us. First I'd like to
• 05:50introduce our faculty. We
• 05:51have doctor Lisa Latanza,
• 05:52who also serves as the chair
• 05:54of our orthopedic department.
• 05:55She's a variety of clinical interests,
• 05:57but one of her special areas is
• 05:59complex adult and pediatric helper.
• 06:01Doctor Kerry Swaggart is
• 06:02our hand section chief.
• 06:04Her specialty is doing well on our
• 06:06wide awake procedures when she
• 06:07can teach you all the intricacies
• 06:09of doing carpal tunnel surgery
• 06:10on wide awake patients.
• 06:11Doctor Ken Donahue and Doctor
• 06:13Sean Lowe are both trained from
• 06:15Elbow to fingertip and truly
• 06:16operate on the whole patient.
• 06:18They both provide an excellent
• 06:20and diverse experience for those.
• 06:21For those who are interested
• 06:22in shoulder and elbow, Doctor
• 06:24Ray Ramirez is our newest higher.
• 06:26He comes to us from Philadelphia and
• 06:28we're very excited to have him as one
• 06:30of his primary clinical interests is
• 06:31in complex pediatric hand. As mentioned, I'm
• 06:33the associate fellowship director, Meg.
• 06:36Special interest is of course
• 06:37in teaching everything about the
• 06:38hand and wrist to our fellows,
• 06:39but my particular love is
• 06:41in hand and wrist trauma,
• 06:42particularly scaffolds
• 06:43and scaphoid nonunions.
• 06:45The curriculum includes an
• 06:46extensive clinical experience,
• 06:48a comprehensive didactic program,
• 06:50and a research program. Which includes
• 06:52a presentation at a regional,
• 06:54national or international level.
• 06:55The call schedule is one in three from
• 06:58home, but all call activity is
• 07:00supervised by faculty as the ACGME
• 07:03prohibits independent responsibility.
• 07:06The weekly schedule includes
• 07:07operating room time and
• 07:08clinic time, but the breakdown favors
• 07:10the operating room over the clinic.
• 07:13Dedicated advanced practice providers
• 07:15provide additional support.
• 07:17A little bit about our philosophy.
• 07:19We know that our hand fellows
• 07:20come in with a diversity.
• 07:22Experience and the diversity of what
• 07:24they look for in a hand fellowship.
• 07:26Every fellow has a different idea
• 07:27about the surgeon that they want to
• 07:29be when they finish their training.
• 07:30From the orthopedic side,
• 07:32we try to maintain those goals
• 07:34and everything that we do.
• 07:35We provide a flexible training environment
• 07:37where fellows can have exposure to hand,
• 07:40shoulder, and elbow if they wish,
• 07:42or for those fellows who have
• 07:43less interest in children, elbow.
• 07:44We try to tailor our experience
• 07:46to meet those goals.
• 07:47We make sure that we treat all of our
• 07:49fellows with kid legality and respect,
• 07:51and we believe that we put out.
• 07:53An extraordinary group of fellows who go
• 07:55into the world with professionalism and
• 07:57skill to contribute to their communities.
• 07:59Finally,
• 07:59just a little bit about the details of what
• 08:01it's like to be in the orthopedic side.
• 08:02When you're rotating with us
• 08:04as a hand fellow,
• 08:04you spend on average about two days
• 08:06a week in clinic and the rest of
• 08:07your time in the operating room.
• 08:09Of course, when they're interesting
• 08:11or unique cases going on,
• 08:12we encourage fellows to go
• 08:13to those cases and get the
• 08:14experiences that they want to get.
• 08:16You tend to split call and rounding
• 08:18with the residents on the hand service,
• 08:20and we found that working with the
• 08:22residents provides actually a huge benefit.
• 08:23Both for the fellows and
• 08:24for our resident trainees,
• 08:26the fellows have an opportunity
• 08:27to participate in a volunteer
• 08:29surgical expedition.
• 08:30With the organization handheld.
• 08:31A wide variety of experience
• 08:33with pediatric hand and upper
• 08:35extremity surgery is possible.
• 08:37Just a word about the match rules.
• 08:38The match works best when everybody
• 08:40follows the rules set out by the
• 08:42NRMP. This means that we will not be calling
• 08:45you to let you know where you
• 08:47stand on our rank order list.
• 08:48Finally, I'd like to say a few words
• 08:50about living on the Connecticut shoreline.
• 08:52My family and I are long term.
• 08:54Residents of Connecticut,
• 08:55there's outstanding dining and culture
• 08:57both locally and regionally. We
• 08:59enjoy local activities such as
• 09:01skiing and boating. The closest
• 09:03skiing is just 25 minutes from our house.
• 09:06Fun fact, did you know that snowmaking
• 09:08was invented in Milford, CT in 1950?
• 09:12The Fellowship supports team building
• 09:14events such as Golf Day and Boat Day.
• 09:18Both ends with a lively dinner in one
• 09:20of the many amazing restaurants in
• 09:21our country. Thanks for
• 09:23listening and for your interest in
• 09:24our fellowship and we are looking
• 09:25forward to training our next group
• 09:27of outstanding future hand surgeons.
• 09:34So here we are at the end of our tour.
• 09:36With the more than 200 year
• 09:38history and legacy of clinical
• 09:39and educational excellence of the
• 09:41hospital and the medical school.
• 09:44Our hand fellowship has
• 09:45established its own legacy.
• 09:47It's an exciting time for hand surgery
• 09:49at Yale University and our Hand
• 09:50Fellowship is an outstanding opportunity.
• 09:53I hope to see you soon.
• 09:55Be well and stay safe.
• 10:03Oh, and by the way,
• 10:05I have many more fun facts.
• 10:07Some of them are even true.