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American Association for Hand Surgery

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Leadership Trends at Hand Surgery Fellowships
Nicholas C Schiller, MS, BS1, Amanda Spielman, BS2, Andrew J Sama, BA1, Benjamin I Schachner, MS, MPH1, Chester John Donnally III, MD3 and Seth D Dodds, MD4, (1)University of Miami, Miami, FL, (2)University of Miami, Miller School of Medicine, Division of Plastic and Reconstructive Surgery, DeWitt Daughtry Department of Surgery, Division of Plastic and Reconstructive Surgery, DeWitt Daughtry Department of Surgery, Miami, FL, (3)Jackson Memorial Hospital, Miami, FL, (4)University of Miami / Jackson Health Systems, Miami, FL

Introduction
Understanding the characteristics among current Fellowship Directors (FDs) in the field of Hand Surgery may predict the overall direction of the field and influence the careers of current trainees. We provide a framework for those aspiring to achieve such leadership positions in hand surgery and identify opportunities to improve the position with the potential to diversify leaders' racial, gender, training, and research backgrounds.
Methods
All hand surgery fellowship programs in the United States were classified as either orthopaedic surgery or plastic surgery programs based on their ASSH Hand Fellowship listing. FD characteristics were gathered via author review of current curriculum vitae, institutional biographies, Scopus H-index profiles, emailed questionnaires, and phone calls. Data was interpreted using Pearson correlation coefficients according to Mukaka's Guide for Correlation Coefficients.
Results
Of the 90 programs included, 72 were designated as orthopaedic surgery programs while 18 were listed as plastic surgery programs. Table 1 summarizes the FDs' demographic, education and employment information. The residency program with the highest frequency of attendance was University of Pennsylvania (n=5); the most attended fellowship program was Harvard (n=8). 22 FDs (24.4%) completed two fellowships and 4 FDs (4.4%) completed three fellowships. Table 2 summarizes the FDs' training background and research productivity, including correlation of years as FD with H-index and age with H-index.
Conclusion
This study provides an overview of current FDs within Hand Surgery in the United States and could function as a guide for individuals who strive to become academic leaders in hand surgery as well as direct initiatives to achieve diversity equality. While the field demonstrates growth in its population of female surgeons, overall Hand Surgery has lower percentages of females and minorities in leadership roles than many other surgical specialties. Diversity among leaders may enhance the training experience for the next generation of fellowship directors and enable progress and innovation in the field by offering different perspectives and shared strategic planning. Our community of hand surgeons should pursue efforts to foster diversity in leadership positions, and by doing so, will continue to build professional development frameworks for the future leaders of hand surgery.


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