New Application: Hand Surgery
Review Committees for General Surgery, Orthopaedic Surgery, or Plastic Surgery
ACGME
515 North State Street, Suite 2000, Chicago, Illinois 60654  312.755.5000  www.acgme.org
NARRATIVE SUMMARY OF COMPLIANCE WITH ACCREDITATION REQUIREMENTS
The questions which follow provide programs with an opportunity to systematically describe the manner
in which they comply with accreditation requirements. Responses should be concise and focused.
During the site visit, fellows, faculty, and others will be asked for comment on the information provided.
As a result, those who will be interviewed should read the application prior to their meeting with
the site visitor.
Responsibilities of the Program Director
Describe how the program director will ensure the timely, accurate, and complete collection in the
ACGME Case Log system of operative procedures performed by each hand fellow. [PR II.A.3.f)]
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Resources
1. Describe the inpatient facilities available for fellow education, including the number of beds, and
support staff, as well as clinic and office space for fellow participation in the preoperative evaluation,
treatment and postoperative follow-up of patients for whom the fellow will have responsibility. [PR
II.D.1.a)]
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2. Describe the operative suite(s) and diagnostic facilities, including technologically current equipment
that will be available for fellow clinical education. [PR II.D.1.b)]
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3. Describe the outpatient facilities, including support staff, operating suites, and clinic and office
space that will be available for fellow participation in the preoperative evaluation, treatment and
postoperative follow-up of patients for whom the fellow will have responsibility. [PR II.D.2.]
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4. Describe the library services available for fellow education, including both electronic and on-site
library resources. Indicate whether or not access is readily available during nights and weekends.
[PR II.D.3.a-b)]
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Fellow Appointment
1. What will your program do to comply with the requirement to be committed to promoting the
inclusion of qualified women and under-represented minorities in the profession through its
recruiting? [PR III.A.2.]
Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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2. Enter the number of any type of residents and/or fellows assigned to each site for training in hand
surgery each year. Add rows as necessary. [PR III.B.2.]
Site #1
Type of
Other
Learner
Total/
Year
Present
at any
one time
Site #2
Total/
Year
Present
at any
one time
Site #3
Total/
Year
Present
at any
one time
Site #4
Total/
Year
Present
at any
one time
Site #5
Total/
Year
Present
at any
one time
Educational Program
ACGME Competencies
1. Provide a concise overview of the manner in which the program will ensure that fellows will have
the opportunity to develop and demonstrate competence in the following areas. Comment
particularly on any areas that are not covered.
a) Management of fractures and dislocations, including phalangeal or metacarpal with and without
internal fixation; carpus, radius, and ulna with and without internal fixation; and injuries to joints
and ligaments; [PR IV.A.2.a).(1).(a)]
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b) Management of upper extremity vascular disorders and insufficiencies; [PR IV.A.2.a).(1).(b)]
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c) Upper extremity pain management; [PR IV.A.2.a).(1).(c)]
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d) Wound closure, including skin grafts, tissue flaps (local, regional, and distant), and free
microvascular tissue transfer; [PR IV.A.2.a).(2).(a)]
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e) Fingertip injuries; [PR IV.A.2.a).(2).(b)]
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f)
Tenorrhaphy, including flexor tendon repair and graft, implantation of tendon spacer, extensor
tendon repair, and tenolysis/tenodesis; [PR IV.A.2.a).(2).(c)]
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g) Tendon transfer and tendon balancing; [PR IV.A.2.a).(2).(d)]
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Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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h) Nerve repair and reconstruction, including upper extremity peripheral nerves, nerve grafts,
neurolysis, neuroma management, nerve decompression, and transposition; [PR
IV.A.2.a).(2).(e)]
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i)
Bone grafts and corrective osteotomies; [PR IV.A.2.a).(2).(f)]
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j)
Joint and tendon sheath repairs, including release of contracture, synovectomy, arthroplasty
with and without implant, arthrodesis, trigger finger release, and stiff joints that result from
rheumatoid or other injury management of arthritis, including synovectomy, arthroplasty (with
and without implant), arthrodesis; joint repair and reconstruction, including contracture release
and management of stiff joints; tendon sheath release; [IV.A.2.a).(2).(g)]
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k) Thumb reconstruction, including pollicization, toe-hand transfer, and thumb metacarpal
lengthening; [PR IV.A.2.a).(2).(h)]
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l)
Fasciotomy, deep incision and drainage for infection, and wound debridement; [PR
IV.A.2.a).(2).(i)]
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m) Foreign body and implant removal; [PR IV.A.2.a).(2).(j)]
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n) Replantation and revascularization; [PR IV.A.2.a).(2).(k)]
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o) Amputations; and, [PR IV.A.2.a).(2).(l)]
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p) Arthroscopy. [PR IV.A.2.a).(2).(m)]
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2. Provide a concise overview of the manner in which the program will ensure that fellows will have
the opportunity to develop and demonstrate competence in their knowledge of the following areas.
Comment particularly on any areas that are not covered.
a)
Osteonecrosis, including Kienböck’s disease; [PR IV.A.2.b).(1)]
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Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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b) Tumors, benign and malignant; [PR IV.A.2.b).(2)]
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c) Dupuytren’s contracture; [PR IV.A.2.b).(3)]
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d) Congenital deformities, including syndactyly, polydactyly, radial aplasia, and others; [PR
IV.A.2.b).(4)]
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e) Thermal injuries; and, [PR IV.A.2.b).(5)]
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f)
Rehabilitation and therapy. [PR IV.A.2.b).(6)]
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Didactic Components
1. Provide a list of all the didactic sessions/conferences including scheduled lectures, courses,
seminars and conferences that will be given for one year. Add rows as necessary. [PR IV.A.3.a)-c);
IV.A.4.a)]
Title of Session or
Conference
Topic
Presenter
2. Describe how the program director will ensure that conferences are attended by both the fellows
and faculty members. How will attendance be documented? How will the program ensure that
fellows assigned to participating institutions other than the sponsoring institution will participate in
hand conferences at those sites? [PR IV.A.3.d)-f)]
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3. Describe how the program director will ensure that fellows have adequate time to prepare for and
participate in presentations at conferences. [PR IV.A.3.g)]
Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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4. Describe how evaluation of practices that ensure and improve patient safety will be incorporated
into didactic components of the program. How will fellows be instructed in established patient safety
measures? [PR IV.A.3.h)]
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Clinical Components
1. How will the program ensure that fellows are provided with adequate opportunities to observe and
to manage hand patients with a variety of problems on both an inpatient and outpatient basis? How
will the program ensure that the breadth of patient experience includes the evaluation and care of
individuals through a wide range of ages, of both sexes, and who have acute, subacute, and
chronic conditions? [PR IV.A.4.b)]
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2. Describe the responsibilities of the fellows for inpatients, emergency rooms, outpatient clinics,
operating rooms, and private offices. How will supervision be provided in each area? [PR IV.A.4.d)]
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3. Describe the manner in which the program will ensure that fellows are provided with adequate
opportunities to assume a major role in the continuing care of patients and have progressive
responsibility for patient assessment, preoperative evaluation, postoperative intensive care, other
postoperative management, rehabilitation, and other outpatient care. [PR IV.A.4.d)]
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Scholarly Activity
Summarize program activity in research and other scholarly activity:
1. List the staff who will provide stimulation and supervision of clinical or laboratory research activity
by fellows and identify their particular area(s) of expertise. [PR IV.B.1.]
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2. Describe the time free of clinical duties that will be provided for resident participation in clinical or
laboratory research. [PR IV.B.2.]
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3. Describe the facilities and resources (including space, equipment, support personnel, funding) that
will be utilized to support resident research. [PR IV.B.2.]
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4. Describe the manner in which the program will be designed to promote resident ability to evaluate
medical literature and research. How will instruction in experimental design, hypothesis testing and
research methods be provided? [PR IV.B.1.]
Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Duty Hours
How many months of night float will residents be assigned in each year of the program?
[PR VI.G.6.a)] ...................................................................................................................................... (#)
INSTITUTIONAL OPERATIVE DATA
Report the number of procedures performed at each site that participates in the program during the
most recently completed academic year. Site numbers must correspond to information provided in
ADS.
Procedure (CPT Codes)
Site #1
ARTHROSCOPY
Elbow (29830; 29834-38)
#
Shoulder (29805-07; 29819-28)
#
Wrist (29840; 29843-47)
#
TOTAL ARTHROSCOPY
#
HAND SURGERY
Amputation (24900; 24920; 24925;
#
24930-31; 24935; 24940; 25391;
25900; 25905; 25907; 25909;
25920; 25922; 25924; 25927;
25929; 25931; 26568; 26910;
26951-52)
Congenital (20150; 25335; 26550;
#
26560-62; 26580; 26587; 26590;
26596)
Decompression of Tendon
#
Sheath/Synovectomy/
(24105; 25000; 25111-12; 25115-16;
25118-19; 26055; 26160)
Dupuytren’s (26040; 26045; 26121;
#
26123; 26125)
Forearm & Proximal
#
Fracture/dislocation (23615;
24515-16; 24538; 24545-46; 24566;
24575; 24579; 24582; 24586-87;
24615; 24635; 24665-66; 24685;
25240; 25400; 25405; 25415;
25420; 25425-26; 25515; 25525-26;
25545; 25574-75; 25651-52)
Forearm/Elbow/Shoulder
#
Reconstruction, Releases (23470;
23472; 24006; 24130; 24140;
24145; 24147; 24149; 24155;
24160; 24164; 24300; 24360-63;
24365-66; 24800; 24802; 25490-92)
Site #2
Site #3
Site #4
Site #5
Total
#
#
#
#
#
#
#
#
#
#
#
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Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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Procedure (CPT Codes)
Hand
Fractures/Dislocation/Ligament
Injury (26340; 26540-42; 26546;
26608; 26615; 26650; 26665;
26676; 26685-86; 26706; 26715;
26727; 26735; 26746; 26756;
26765; 26776; 26785)
Hand Reconstruction, Releases,
etc. (25445; 25447; 26130; 26135;
26140; 26340; 26500; 26502;
26516-18; 26520; 26525; 26530-31;
26535-36; 26540-42; 26545; 26548;
26555; 26565; 26567-68; 26593;
26820; 26841-44; 26850; 26852;
26860-63)
Nerve Decompression (29848;
64702; 64704; 64708; 64712-13;
64718-19; 64721-22)
Nerve Injury (64774; 64776; 64778;
64782-84; 64787; 64831-32; 6483437; 64856-57; 64859; 64861; 64872;
64874; 64876; 64890-93; 64895-98;
64901-02; 64905; 64907; 64910-11)
Tendon/Muscle (20924; 20926;
24305; 24341-42; 25260; 25263;
25265; 25270; 25272; 25274-75;
25280; 25315-16; 26180; 26350;
26352; 26356-58; 26370; 26372-73;
26390; 26392; 26410; 26412;
26415-16; 26418; 26420; 26426;
26428; 26432-34; 26437; 26476-79;
26485; 26591)
Tumor/Osteomyelitis (11100-01;
11400-04; 11406;11420-24; 11426;
11600-04; 11606; 11620-24; 11626;
11755; 17260-64; 17266; 17270-74;
17276; 20200; 20205; 20240;
20245; 20265-66; 24065-66; 2407576; 24120; 24125-26; 24134; 24136;
24138; 24149-53; 24155; 25065-66;
25075-77; 25110; 25120; 25125-26;
25130; 25135-36; 25145; 25150-51;
25170; 26115-17; 26200; 26205;
26210; 26215; 26230; 26235-36;
26250; 26255; 26260-62)
Site #1
#
Site #2
#
Site #3
#
Site #4
#
Site #5
#
Total
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
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Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 7 of 9
Procedure (CPT Codes)
Site #1
Vascular Repair / Reconstruction /
#
Replantation / MICR (15756-58;
20802; 20805; 20808; 20816;
20816; 20822; 20824; 20827;
20955-56; 20962; 20969-70; 2097273; 25430; 26551; 26553-54; 26556;
35045; 35206-07; 35236; 35266;
37618; 37799; 64820; 64821-23)
Wound Closure With Graft (15050;
#
15100-01; 15110-11; 15115-16;
15120-21; 15130-31; 15135-36;
15170-71; 15175-76; 15220-21;
15240-41; 15300-01; 15320-21;
15330-31; 15335-36; 15400-01;
15420-21; 15430-31; 15760; 15770)
Wound Closure Without Graft
#
(12001-02; 12004-07; 12020-21;
12031-32; 12034-37; 12041-42;
12044-47; 13120-21; 13131-33;
13160)
Wound I&D Fasciotomy / Wound
#
Preparation (10060-61; 10140;
10160; 10180; 11000-01; 11010-12;
11040-44; 15002-05; 15852; 16000;
16020; 16025; 16030; 20000;
20005; 20103; 20520; 20525;
23930-31; 24200-01; 24495; 25020;
25023-25; 25028; 25031; 25035;
25040; 26010-11; 26020; 26025;
26030; 26034-35; 26037; 26070;
26075; 26080)
Wound Reconstruction with Flap
#
(14000’ 14020-21; 14040-41; 14300;
14350; 15570; 15572; 15574;
15600; 15610; 15620; 15650;
15734; 15736; 15738; 15740;
15750)
Wrist Fracture/Dislocation (25107;
#
25240; 25320; 25430; 25525-26;
25545; 25606-09; 25628; 25645;
25651-52; 25670-71; 25676; 25685;
25695)
Wrist Reconstruction, Releases,
#
Arthrodesis, etc. (25085; 25105;
25107; 25210; 25215; 25230;
25240; 25259; 25320; 25337;
25350; 25390; 25430-31; 25440;
25800; 25805; 25810; 25820;
25825; 25830
TOTAL HAND SURGERY
#
OTHER
Site #2
#
Site #3
#
Site #4
#
Site #5
#
Total
#
#
#
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#
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Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
Page 8 of 9
Procedure (CPT Codes)
Bone/Cartilage/Fascia Grafts
(20900; 20902; 20910; 20920;
20922; 38220)
Closed Treatment of Fractures
and Dislocations (23605; 24500;
24505; 24530; 24535; 24560;
24565; 24576-77; 24600; 24605;
24620; 24640; 24650; 24655;
24670; 24675; 25500; 25505;
25520; 25530; 25535; 25560;
25565; 25600; 25605; 25622;
25624; 25630; 25635; 25650;
25660; 25675; 25680; 25690;
26600; 26605; 26607; 26675;
26700; 26705; 26720; 26725;
26740; 26742; 26750; 26755;
26770; 26775)
Miscellaneous Insertion or
Removal of Devices (11981-83;
20670; 20680; 20690; 20692-94;
26320; 26641; 26645; 26670)
Nail Surgery (11730; 11732; 11740;
11750; 11752; 11760; 11762; 11765)
TOTAL OTHER
Site #1
#
Site #2
#
Site #3
#
Site #4
#
Site #5
#
Total
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
Hand Surgery
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 4/2015
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