Global Hand Surgery Fellowship Education: Program-Reported Characteristics and Competencies

Hand Surgery Fellowship is the mainstay for training of hand surgeons globally. Despite this, a standardized curriculum for hand surgeons has yet to be established, and discrepancies between Hand Fellowship offerings, including operative exposure and program requirements, persist. The purpose of this study was to characterize what Fellowship programs globally promise to teach their Fellows, and how they do this.

An Internet search for Hand Surgery Fellowship programs was conducted between March 3, 2024 and February 8, 2025. In addition to the primary search, programs were found through the International Federation of Societies for Surgery of the Hand and affiliate society websites. Only Fellowships that were recognized by national regulatory bodies were included.

A total of 218 program websites were identified across the United States, the United Kingdom, Canada, Europe, Australia/New Zealand, Asia, Africa/Middle East, and South America. Mentorship/apprenticeships and rotation-based programs were the most common training approaches. Trauma surgery was a universal focus of Hand Fellowships globally. Programs supervised by orthopedic faculty were more likely to offer training in shoulder, elbow, and arthroscopic surgery, whereas programs supervised by plastics/mixed departments were more likely to include peripheral nerve, congenital, microsurgery, and replantation surgery.

Program websites in various regions globally possess different levels of detail and emphasize different aspects of surgical training in their descriptions. The United States had the most programs and included the greatest level of detail in their program descriptions. Reported obtainable clinical competencies varied with geographical region and faculty specialization. Recommendations are suggested.