What is an ideal hand surgery training pathway? Insights and reflections from a global survey

Surveys on hand surgery training and assessment were administered alongside the 15th IFSSH (International Federation of Societies for Surgery of the Hand) congress in 2022. Hand surgeons and IFSSH-affiliated national societies were invited to complete one of two surveys, with responses from 1108 surgeons (from 87 countries) and 46 hand societies. Most countries provide training through the parent specialties of orthopaedic and plastic surgery, with four countries providing hand-only training. The minimum number of postgraduate years to become certified in hand surgery ranges from 4 to 12 years. There are wide variations in curricula, operative requirements, assessment (formative and summative) and fellowship completion. Regarding residency satisfaction and preparedness (for independent practice), hand-only trainees rated far above the international means. The surgeon, societal, financial and patient benefits of training in a parent or hand-only specialty are discussed. The identified facts and opinions provide insights for the future planning of hand surgery training and assessment worldwide.