• Clifton Meals and Meredith Osterman.
• Department of Orthopedics, George Washington University School of Medicine and Health Sciences, Washington, DC; Philadelphia Hand Center, Philadelphia, PA. Electronic address: cliftongm@gmail.com.
• J Hand Surg Am. 2015 Apr 1;40(4):783-9.

PurposeTo investigate expectations, logistics, and costs relevant to the hand surgery fellowship application process. We sought to discover (1) what both applicants and program directors are seeking, (2) what both parties have to offer, (3) how both parties collect information about each other, and (4) the costs incurred in arranging each match.MethodsWe conducted on-line surveys of hand surgery fellowship applicants for appointment in 2015 and of current fellowship program directors.ResultsSixty-two applicants and 41 program directors completed the survey. Results revealed applicants' demographic characteristics, qualifications, method of ranking hand fellowship programs, costs incurred (both monetary and opportunity) during the application process, ultimate match status, and suggestions for change. Results also revealed program directors' program demographics, rationale for offering interviews and favorably ranking applicants, application-related logistical details, costs incurred (both monetary and opportunity) during the application process, and suggestions for change.ConclusionsApplicants for hand surgery fellowship training are primarily interested in a potential program's academic reputation, emphasis on orthopedic surgery, and location. The typical, successfully matched applicant was a 30-year-old male orthopedic resident with 3 publications to his credit. Applicants rely on peers and Web sites for information about fellowships. Fellowship directors are primarily seeking applicants recommended by other experienced surgeons and with positive personality traits. The typical fellowship director offers a single year of orthopedic-based fellowship training to 2 fellows per year and relies on a common application and in-person interviews to collect information about applicants. Applicants appear to be more concerned than directors about the current state of the match process. Applicants and directors alike incur heavy costs, in both dollars and opportunity, to arrange each match. A nuanced understanding of the match process suggests specific changes and may help reduce these costs.Type Of Study/Level Of EvidenceEconomic and decision analysis V.Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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