Hand Surgery, Upper Extremity, and Microvascular Surgery Fellowship

Program Overview
Application Process
Application Requirements
ACGME Additional Requirements
Foreign Medical Graduates
Visa Sponsorship
Interview Selection Criteria
Interview Dates
Contact us
Social Media

Program Overview

Program Training TirectorMarc J. Richard, MD
Associated FacultyDavid S. Ruch, MD, Suhail K. Mithani, MD, Warren C. Hammert, MD, Tyler Pidgeon, MD, Christopher Klifto, MD, Neill Y. Li, MD, Yaw Boachie-Adjei, MD, Detlev Erdmann, MD, Linda Cendales, MD

Fellowship Dates: August 1 through July 31
Number of fellows: Three (ACGME accredited)

The purpose of the Duke Orthopaedic Hand, Upper Extremity, and Microvascular Surgery Fellowship is to offer fellows special knowledge and training in the management of:

  • Acute hand and upper extremity trauma
  • Hand and upper extremity microvascular emergencies
  • Reconstructive hand and upper extremity conditions
  • Congenital upper limb deformities
  • Brachial plexus and peripheral nerve injuries

Two residents, three fellows, and one plastics resident are each assigned to one or more faculty member(s) who has some or all of their practice dedicated to hand and upper extremity surgery. The hand trauma call schedule includes a dedicated attending and hand fellow daily. Hand call includes replantation / microvascular emergency services, for which our institution is a major referral center for the entire southeast United States. Our faculty appreciates a mentorship-type relationship with the fellows who are expected to participate in teaching residents and students and to gradually assume greater responsibilities in patient care in clinic and in the operating room over the course of the fellowship year, under the direct supervision of the faculty. Highlights of clinical exposure include:

Adult reconstruction includes experience in treatment of osteoarthritis (including post-traumatic) and rheumatoid arthritis for the upper extremity, Dupuytren’s contracture, nerve compression syndromes, scleroderma and vascular insufficiency, and tendon reconstructions. In association with the orthopaedic oncology service, treatment of benign and malignant tumors of the upper extremity is included in the education of the residents and fellows.

Trauma includes treatment of fractures and dislocations of the upper extremity, flexor and extensor tendon injuries, nerve injuries, compartment syndromes, and replantation / microvascular emergency services. Experience is obtained for both acute, sub-acute and chronic injury presentation.

Brachial Plexus and Peripheral Nerve Injuries include the evaluation and management of both adult and pediatric patients with traumatic and birth-related brachial plexus injuries as well as the treatment of acute and chronic peripheral nerve injuries.

Congenital hand includes treatment of all birth-related injuries, such as congenital absence of the thumb, radial and ulnar club-hand, syndactyly, and cerebral palsy.

Free-tissue transfer includes our significant experience with free, vascularized fibular grafting, soft tissue reconstruction with local, regional, and distant tissue transfer.

Clinic and operating room experience

Fellows actively participate in both the clinic and the operative room. In the clinic and in the operating room, a structured mentorship education program encourages the development of examination skills, diagnostic test interpretation, treatment decision making, pre- and post-operative management of patients with upper extremity disorders, and surgical techniques and principles.

Education / conferences

The following conference schedule occurs on a weekly basis:

  • Tuesday: Core Lecture
  • Wednesday:  Core Anatomy / Surgical Skills Laboratory
  • Thursday:  Hand – Radiology Conference (1x/month)
  • Friday: Indications Conference

Also, there is a monthly Hand Journal Club.


An extensive orthopaedic research laboratory, including a hand and microvascular lab, is available to residents and fellows. A modern fresh cadaver laboratory fully equipped with hand surgery instruments and a microscope is available for the practice of surgical procedures and anastomosis dissections of the upper extremity. It allows for extensive research opportunities as well as the development of microsurgical skills.

Each fellow is expected to design, to lead and to complete a research project during the fellowship year. Many opportunities exist throughout the year to participate in various research projects, book chapters, review articles, based on an individual fellow’s interest.


Each rotation is two months in duration. Fellows rotate with the senior faculty twice during the year.

























Application Process

Accepting applications: 2025-2026 (Fall 2023)
Match participation: NRMP (#1529263F0)
ACGME accredited program#: 2633621022

Application deadline: December 15

To be considered for this fellowship, you must have completed a general surgery, orthopaedic surgery or plastic surgery program accredited by one of the following:

  • Accreditation Council for Graduate Medical Education (ACGME)
  • American Osteopathic Association (AOA)
  • Royal College of Physicians and Surgeons of Canada (RCPSC)

Application Requirements

Applicants should apply through the American Society for Surgery of the Hand (ASSH) by completing an online application and providing other requested documents.

  • ASSH Universal Hand Application
  • Brief personal statement
  • Picture
  • Curriculum vitae
  • List of Publications and presentations
  • List of hobbies
  • Copy of USMLE/COMLEX transcript (all three steps; passed within three attempts)
  • Three letters of recommendation:
    • One of which should be from the chairman or program training director of your training program
    • Letters must be on official letterhead and may not be older than six months
  • Copy of medical school transcript
  • ECFMG Certificate (applicable to international graduates)

ACGME Additional Requirements

To be eligible for ACGME-accredited fellowship training, you must adhere to the following application requirements:

  • You must provide proof that you have taken and passed all three steps (within three attempts) of appropriate medical licensure examinations (USMLE/COMLEX). The North Carolina Medical Board requires this and is a Duke institutional policy for all graduate medical trainees—whether U.S. or international medical school graduates at the PGY-3 level or higher; as well as, qualify for a resident training license in the state of North Carolina to be eligible for employment at Duke University Hospital.

Foreign medical graduates: additional requirements

Foreign medical graduates must hold a valid and current ECFMG certificate in addition to meeting the above requirements. Your ECFMG Certificate must be valid as of the start date of the program. For foreign nationals who are medical graduates of LCME-accredited schools in the U.S., Canada, and Puerto Rico, copies of the diploma will suffice in lieu of an ECFMG certificate.

Visa Sponsorship

The Department of Orthopaedic Surgery will provide visa sponsorship for a J-1 Clinical House Staff Visa (ECFMG sponsored); which is sufficient for clinical fellowship training for individuals participating in an ACGME accredited fellowship. 

As standard practice, the department does not sponsor an H1-B visa for a couple of reasons; 1) the H1-B isn’t required for accredited fellowship training and 2) the H1-B comes with fees of approximately over $3000 where the division does not have the funding. For extenuating circumstances, applicants that are invited to interview may wish to request an exception to this rule when accepting the offer to interview.

Interview Selection Criteria

Fellow applicants are selected for an interview based on preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity. In particular, we consider:

  • Educational accomplishments
  • Letters of Recommendation
  • Experience
  • Research

Important intangibles that are fundamental to the selection process include:

  • Leadership
  • Work ethic
  • Communication skills
  • Enthusiasm

Additional attributes that our committee considers:

  • Determination
  • Strength of character
  • Overcoming obstacles

Fellow applicants are selected for appointment to our program based on their interview and review of the above-listed criteria.

Interview Dates

For interview date(s), please refer to "Fellowship Progams At-A-Glance" => Click Here.

Interviews are extended to applicants either late Fall or early Winter for interviews occuring in the preceding Winter months.

Contact us


Cheryl DePaolis, Fellowship Program Coordinator

Wendy Thompson, C-TAGME, Senior Program Coordinator, Medical Student Sub-Internship and Residency Training

Tyranicia Green, Program Coordinator, Residency Training and CME Associate for Orthopaedics

Social Media

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Twitter: https://twitter.com/DukeOrtho