A Message from the Program Directors

December 01, 2022

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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.