The Hand and Microsurgery Fellowship Program

Overview

The Hand and Microsurgery Fellowship is a program in the Department of Musculoskeletal Diseases at Tampere University Hospital (Tays). The fellowship program is directed by Chief Hand Surgeon Olli V. Leppänen, M.D., Ph.D. The fellow will be involved in both emergency and elective hand surgery. Tampere Surgical Education Centre and University of Tampere provide excellent laboratory facilities for practical surgical training. One half day per week will be reserved for clinical or basic laboratory research.

Hand surgery is an independent medical specialty in Finland and most hand surgeons are not directly involved in general orthopedic or plastic surgery practice. Therefore the Hand Surgery Fellow will be able to focus on the treatment of upper extremity conditions. The official languages in Finland are Finnish (88% of the population) and Swedish (5%). Eighty-two percent of the population can speak some English and almost all young people have good conversation skills in English. Our hospital regularly hosts international students and fellows and most of the staff speaks English.

Our Faculty

Olli V. Leppänen, MD, PhD, Fellowship Director
Jarkko Jokihaara, MD, PhD

Affiliated Hand Surgeons

Camilla Hellevuo, MD
Margit Karelson, MD
Antti Kaivorinne, MD
Patrick Luukinen, MD
Antti Paukkunen, MD
Anniina Ukkola, MD, PhD
Henrikki Rönkkö, MD, PhD
 
In addition there are 3 hand surgery residents and 3 dedicated hand therapists in the Department of Musculoskeletal Diseases in Tays.

Training Institution

The fellowship is based at Tampere Central University Hospital (Tays). Tays is an academic referral hospital and has also the major Emergency Department which serves a large area. During the course of fellowship program, the fellow will be working with both traumatic and elective hand surgery. We provide treatment for all types of joint, nerve, vascular and tendon conditions as well as fractures and injuries to multiple tissues, for example, replantation surgery.

Tays is one of the only three hospitals in Finland which provide around-the-clock replantation emergency services. Approximately 50 upper extremity revascularizations or replantations are carried our each year in Tays. All bone and soft tissue injuries of the wrist and hand are treated by hand surgeons, while, for example, some distal radius fractures are operated by hand surgeons and others by orthopedic surgeons depending on the fracture pattern and patient flow between departments. Hand surgeons are responsible for all treatment of complex combined injuries and nerve injuries of the upper extremity.

The Department is internationally known for the pioneer work by Professor Simo Vilkki. His innovative microsurgical work is now continued by our congenital anomaly team. Professor Vilkki still visits the clinic regularly. Toe-to-hand transplantations are carried out about 1-2 times a year. Brachial plexus injury patients (both pediatric and adult) are treated regularly in Tays and overall there are approximately 50 operations per year.

The Department of Musculoskeletal Diseases has also a dedicated upper extremity orthopedic team directed by Antti Launonen, MD, PhD. The Fellow is encouraged to make use of the supervision and guidance of his team, as well. It is also possible to be involved with the work of plastic surgeons led by Minna Kelloniemi, MD, PhD.

Program Structure

The Fellow will see a variety of upper extremity conditions including, for example, complex trauma, post-traumatic reconstruction, distal radius fractures, wrist pain, osteoarthritis, compression neuropathies, and congenital deformities. According to the personal goals/interests, the fellow can further choose how the six-month period will be divided between working with microsurgery team (congenital, tetraplegia, nerve) and wrist team (wrist, forearm and tendon). The fellow is allowed to perform operations under the guidance of a team member, but is not allowed to operate alone. Assisting in the more complex cases is the main learning method during the fellowship.

Educational Program

Weekly Hand Conference. On Friday mornings, a resident or fellow will prepare a 30-45 minute scientific presentation which is followed by a lively discussion.

Weekly Team Meeting. On Monday mornings, current administrative or educational topics are discussed. Twice in every six months there is a journal club.

Monthly Surgical Training Program. In cadaver dissection sessions at the Tampere Surgical Education Center it is possible to dissect and practice surgical operations in top-class facilities. A resident or fellow will give a short presentation about the operative technique prior to the session.

Basic microsurgery training course. The laboratory training program is intended for an incoming fellow or resident. It is arranged by the University of Tampere and there is a fee for the course.

Research

All hand surgeons at our Department are involved in research. There are many ongoing and future research opportunities at the Department of Hand and Microsurgery and Fellows are encouraged to get involved with the research projects. In the recent years our Department has been the most productive hand surgery unit in Finland. If a prospect Fellow has research experience or strong research interests it is advisable to be in contact before starting the fellowship period. The director of research is Jarkko Jokihaara, MD, PhD.

Salary and Vacation

The fellow is paid a salary of approximately 1600 euros/month. The fellow is entitled to approximately two days of paid vacation per month.

Application Process

Please see the table above to time the application process. The applicant is asked to send application to olli.leppanen@pirha.fi. The application should include:

• an informal application
• Curriculum vitae
• list of previous training
• a letter of recommendation

More information

• A report written by Indrek Soosaar, M.D. about the fellowship (in 2018) (pdf)
• A report written by Daisuke Kaji, M.D.about the fellowship (in 2020) (pdf)
• A report written by Mwanaidi Muhavi Ayumba, M.D. about the fellowship (in 2021) (pdf)
• A report written by Kaur Kersalu, M.D. about the fellowship (in 2023) (pdf)

Further information: olli.leppanen@pirha.fi