Welcome to the upper hand, where Chuck and Chris talk hand surgery.
We are two hand surgeons at Washington University in St. Louis here to talk about all aspects of hand surgery from technical to personal.
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Oh, hey, Chris.
Hey, Chuck, how are you?
I am pretty well, how are you today?
I'm doing well, you know, all things considered, as we've talked about before, you know, it looks like there might be some light at the end of the tunnel in many domains.
I think there's light. I think there's light. Yesterday was my wife's birthday, which was always a good time. And I think she enjoyed watching the inauguration. And yeah, it feels like the things at least the seriousness with which we all address COVID not to be political. But I think that has taken a turn.
Well, happy birthday to Talia, big supporter of the podcast. I think.
She's a supporter, she cracks up, you know, at us with doing the podcast and our cracking ourselves up. But yes, she's a definite supporter.
Yeah. Have you had your. Have you completed both doses of your vaccination yet?
I have. I think I mentioned I fell into the old group. And so I was in the first vaccinated group. First time I've been really happy to be old. My first one was super easy, little sore arm like a flu shot. The second one, my arm was more sore. I had a headache, a little malaise, but never fevers. And I was able to work the next day. But I've heard reactions running the gamut.
Yeah, I've heard a couple of people either regretting that they had clinical obligations or flat out canceling clinical obligations right afterwards or downwind. So I actually had my next dose scheduled about a week from now. And I moved it towards the end of the day, because I clearly didn't want to have it before surgery.
Yeah, I did mine on Friday. So it really helped to remove that not remove it, but really helped with the process. I'm sorry, I thought you'd had both of them too. I guess that means you're really really, really young.
Yeah, or just really, really negligent. But I was checking my spam spam inbox quite a bit waiting for the call from coach, but I'm excited about it. I'm excited. A lot of our residents and fellows are getting their doses and a lot of our medical workers on the frontlines. It's great to see hopefully the rollouts will only improve as it gets to the general public.
Yeah, absolutely. I think one of the things not to get too much on the COVID track is with this new variant, which seems to be partially responsible for California's debacle. It's just so important, because I do think the new variant will be successfully addressed with the vaccine, at least that's my understanding that the more people that get vaccinated, the faster we get them vaccinated, the less this new variant will affect us all.
Let's get some shots in arms then.
Absolutely. Hey, any good reviews out there?
Yeah, we did have a good review. So this is from our listener survey. So this is from somebody who said the following. And we really appreciate this. I heard about this podcast from Dr. Lisa Cruz. I've been working with her for about a year now as her NP. She is amazing and so knowledgeable. I believe she trained with Dr. Goldfarb. I have learned so much from the podcasts that I take back to my clinical practice. I worked in orthopedics for years and never saw myself specializing in hand.
However, I've fallen in love with daily challenges. And also the reward of helping change someone's life with starting something as simple as a carpal tunnel release. I love that I work with a surgeon who sort of knows you guys personally kind of like celebrity status. Now if I had a dime for every time somebody said, I know Chuck Goldfarb, I'd have about 30 cents. So thank you for the survey. You know, here's a funny story. Actually. I was your fellow and it was the end of my
rotation. And I brought in a book for you to sign because I thought it would be really nice if my attending signed the book that he wrote. And then you laughed at me and didn't sign the book. So I don't know how you're handling your celebrity status. Chuck.
Oh, I sign lots and lots of signatures on books. I give my autograph out all the time now. Just kidding. I you know, it's so interesting. I do remember that it was extraordinarily awkward.
Yeah.
But it felt weird. You know, it's kind of reminds me of my son was a very good basketball player in high school. And the little kids would come up to him and ask for his autograph and he asked how to handle that. And I said, I don't know they're asking for your autograph. I guess you give it. I guess I didn't follow my own advice very well.
Yeah, exactly. Well, thank you for the review. And thank you for filling out the survey. And we want everybody is, if they can to please fill out the survey. It helps us kind of fine tune what we do here helps us make sure that we are talking about what you guys want to talk about. So that's at theupperhandpodcast.wustl.edu, which is also listed in the show notes. And of course, you can always email us any comments and feedback at handpodcast@gmail.com.
Yeah, along those lines, perhaps we should give away a mug today.
Yes, let's do it. So you've been the man to call out random numbers. So I will give you the chance to call out random numbers from one to 66.
I'm gonna go low. So I'm gonna go number three. lucky number three.
All right, so. Okay, here we go. Lucky listener. Number three, whose first name is Eileen. I'm not going to read your entire email address on on the air. But I will email you and contact you to to collect your upper hand coffee mug, also hoping that you live in the US. But it's cool if you don't.
I had the pleasure of sending out a couple of mugs last week, one to a winner. From our last month's drawing took a while to get in touch with one another. And then of course, we sent one to our fantastic guest last week.
Yeah, Dr. Moore was incredibly well received as a guest. Of course, we knew that she had her own fan club, but I was I actually listened to the podcast from start to finish. Just because I enjoyed the conversation. I wanted to hear it again. And I really liked it. I'm glad you tolerated three straight nerve episodes, Chuck.
I just need a little bit of a breather. But we'll come back with more nerve. In case anyone's discouraged out there.
Yes. And to to Drew I know, we took a while to send you the mug that's on me for family to email you but thank you for emailing me. We certainly appreciate that. And Chuck, I had an interesting case recently. Can I tell you about it?
As long as it's not nerve Chris, please do tell.
It is not nerve it actually kind of falls right up your alley. And the trainee who I was working with convinced me I should do something that Dr. Goldfarb did. So we had a proximal pole scaphoid non union or almost I guess non union and evolution neglected diagnosis came to me about three or four months after the injury itself and tried to play through the
pain. And the you know, the fracture, you know, the fracture edges had started to kind of corticate, there was no sign of necrosis or any sort of, you know, changes in the proximal pole. And then, you know, fortunately, there was no, there was no angulation there was no humpback deformity on the l teral film and on a CT scan. S I thought, you know, why d n't we go ahead and do a d
rsal approach. And we'll plug i some cancellous distal radius autograft, we'll probably have t debris the non union site, obviously being cognizant to avoid the dorsal blood supply. And I remembered two things, y u know, one of them being o r partner, Ryan Calfee, you kno , kind of mentioning, you kno , usually when you get in ther , it all looks like one, you can t really see the non union si e that well. And then the questi n is, is it too invasive and t o destructive to try and take so
e of that down? Or does drilli g across it do enough? And t e second thing was that our fell w Shobhit Minhas said, you know what Dr. Goldfarb did for thi case is that he just took th graft and packed it down, yo know, with the screw. I said you know, that's a great idea. have not done that yet. Wh don't we try that? So tell m about how you actually pack th grafting because we had a coupl different we ended up getting t something I really liked. Bu technically, how do you do that
Well, a couple comments before I jump to that. So first of all, it is that is an interesting case that will resonate to every listener, because proximal pole fractures and non unions are just a fact of life. I will say I remember in my fellowship, and let's I'll date myself. So my fellowship in Cincinnati was 2001, 2002. And what we would do in those cases is we would create a little window and plug in our graft through a little window without
taking the whole thing down. But about that time is when Joe Slade started popularizing this dorsal approach which had been forboden because of the worries about the blood supply. But as we know, the blood supply is much more distal. And so I think you can be very safe with a limited dorsal approach, not a percutaneous I think percutaneous has fallen generally out of favor but a
small approach. My approach is usually about a two centimeter incision, I make it a little ulnar and a little proximal to the wrist right at the level of Lister's tubercle and then dissect down to bone, identify the ligament, work just off the ligament, place my k wire, over drill, take distal radius cancellous bone graft, pack it in and then place my screw. I don't formally take anything down. And again, that's mainly from Joe Slade's work and I've
been very happy with that. I think both the drilling and the packing of the bone graft in the same area not packing too deep down the canal, but just packing near the area of concern really does disperse the bone graft in The area that it needs to be. And while nothing's perfect, I've been very happy with that approach. But how did you guys handle it?
Well, actually a couple questions on that. So when you say over drill, what do you mean by over drilling? Are you advancing the K wire? So it's parked in the trapezium and then drilling? Or what do you mean by that, are you changing out the drill bit?
Yeah, I'm sorry, I made it sound more impressive than it is I simply use the drill bit for the appropriate screw for the appropriate headless screw. And you know, in this case, number one, the fracture is not moving. So you don't have to worry about keeping the K wire in. And number two, you got to take the K wire back out before you pack your cancellous bone graft in. Now some would argue, you should then re insert your k wire to truly know where your screw is
going. I don't generally do that, because I think your screw has an obvious path to travel. So nothing fancy in that regard.
Yeah, you know, I'm a little neurotic. So after we drilled, you know, the K wire came out, and that made me a little, you know, irritated to be honest with you. So we had harvested our bone graft and just, you know, honestly used the K wire to just kind of pack it in and then reinserted the wire, I am a little neurotic. So I checked the X ray and made sure it was an exact same path, all the chances of it being anywhere else are really quite
slim. And then I inserted the screws, you know, obviously with the screw helping advance that graft, I think to where it needed to go. One thing that we talked about in conference one time was, you know, where you harvest that cancellous autograft from. Obviously, you don't want to leave any sort of irritation in the path of the EPL. Where do you go to get that? You know, and how do you do it?
Yeah, I think that's right. And there are case reports. And I think there's been some that I've been aware of, thankfully not my patients where the EPL has ruptured. If you truly just, you know, some people say take a rongeur and take off Lister's and make it seem like a no big deal. Well, that is easy to do. But it can create a rough surface and that theoretically is that, it does put the EPL tendon at risk. And so what I do is I work a little proximal to Lister's tubercle.
And I work a little radial to Lister's tubercle because we know that the ECRB and ECRL are not truly moving very much. And if you have a smooth surface, I think it's pretty easy and straightforward. What I do is I quote unquote, drill with a very small curette. And then I use a larger curette to harvest a bone graft. And honestly, you don't need a lot. So it's not time consuming, it's not hard. One other technical Pearl, I would say, is, we talked about placing our screws center center in the
scaphoid. And that's obviously the goal. And there's good work out of Seattle and other places, emphasizing that being the goal. In this case, the goal is really for the screw to capture as much of the proximal pole as possible. And so sometimes it doesn't end, the screw may not be center center. And you may actually have to impinge a little bit on the ligament to really get that screw at the best possible starting point to grab as much scaphoid as
possible. So to me, that's been an important lesson I have learned.
Yah, you certainly don't want that proximal pole to start to disintegrate because you're not capturing as much of it as you can. And you're kind of too close to the margin there. So are you a believer in ever putting in two screws in the scaphoid? There are some new papers coming out about that. I have not converted yet, but maybe I haven't had the right case yet.
Yeah, I would say the same. I'm not I don't believe in it yet. I've not been convinced. I do spay you know, pay special attention to cost. But it's worth it. If you avoid a non union, obviously. And and you know, unfortunately for a proximal pole, that's probably not a choice, I guess you could put a couple of micros in maybe, but to me, that doesn't make any sense. I think that's thinking about maybe the waste non union and people talk about plating too. I'm not sure I buy that. Personally.
Yeah, plating the sca- The literature on the plating of the scaphoids, I think is a little too heterogenous for me to go down that path. And technically, it seems like a very long run for a short slide. But I think maybe in the right setting where you have some deformity that you're really trying to correct. And you know, provide some support for that volar cortex. Maybe that's the right case. Fortunately, I have not had that case yet.
All right. Well, I think we should jump into the show topic, which I think is relevant to everyone listening, although we'll be more relevant to some compared to others.
Well, you know, it's funny that the reason I wanted to talk about this topic is that we were doing our residency virtual interviews a couple of weeks ago, and one applicant did mention that he had listened to the podcast and I said okay, which episode and, and he said the one about interviewing for residency and fellowship. And that was one of our very first episodes. I remember recording it right after we had finished doing our fellowship interviews last last early, you know, kind
of late winter. And I was wondering, is all the advice that we gave still relevant because clearly things are different now with virtual interviews. So how do you on your side of things, how do you, how do you think about the concept of interviewing people for residency and fellowship virtually? Because you're involved in the orthopedic residency, the pediatric fellowship and hand fellowship?
Yeah, just adding to my zoom fatigue, to be honest with you, but but it is, it is a very different type of zoom use. And we are, frankly, we are using zoom others have
used offshoots of zoom. I want to step back for one second, and and reply to your comment which, that when, when the applicant suggested that he had listened to the podcast, the natural follow up is oh, you know, which one or if the applicant says I love history, I read a lot of history books, the follow up question will be Tell me about a history book you read recently.
So to all of those of you applying, be careful what you say and mean what you say, because I don't think Chris had any ill intent with the follow up question. It's just a natural follow up question. And if someone says they like history, and they read books, I love history and read books, too. I want to talk about history books. So just make sure you kind of put your money where your mouth is, so to speak.
Well, actually, when I was, when I was interviewing for residency, it's actually the program I ended up matching, they had different types of rooms, right. So like, there was a skills room, and there was a research room, etc. And in the skills room, I was getting peppered with questions. And you know, they're like, what do you like to do for fun? I said, Well, I just ran the Miami marathon. And then it was like, what kind of running shoes did
you wear? I thought the natural question would be like, what was your time? Or like you know? I guess they're really trying to get me there. And I don't think I can remember the exact type of asics that I wore. So maybe I lost some points.
You may have? Or maybe they thought you were not a real runner? Who knows?
I'm definitely not a real runner. That's for sure.
Yeah. And I would say in these days, I'm just a jogger. I'm not even a runner anymore. That's how much I've declined. So let me get back to your question. So it's interesting to me. You know, we we've talked about this a little before, it probably deserves more conversation in the future. But what about our current pandemic practices will carry forth? What will we do three years from now there we're doing
today. And it's interesting, when I think about residency interviews, I think they have to go back to the way they were before. Because five years is a long time for a resident to spend in a location, I think we probably need to offer them the opportunity to see the city see the program, see the hospital meet us in person. It's interesting, when I think about fellowship interviews, and I may be in the minority, and this certainly will need to be fleshed out. It's only a year.
And you know, fellows can, fellow applicants can spend 1000s upon 1000s of dollars traveling to multiple fellowships. And maybe zoom interviews are good enough. And we've had some conversations around that. Certainly it's not in an effort to discourage people from visiting. But it's in an effort to simplify the process. I think zoom, and I'll stop talking in a second. I think zoom interviews are the best of a tough situation, it's the best we can do right now. I
think they are valuable. But I would also agree that it's not the same as an in person meeting.
Yeah. And I think that, you know, I think I agree
Yeah, it also gets to, we could go in a lot of with you about the residency thing. And then even, you know, the, the orthopedic trauma fellowships in the US, they were going through a centralized system, where they were doing an initial round of interviews at I believe, at the OTA meeting, in an effort to try and narrow down
and save money. You know, there are there have been some papers published on the expense for fellowship interviews, I think it runs into like, somewhere between eight to 10,000, maybe more. And I remember, I racked up quite a bill, you know, traveling the country. And I didn't go on a ton of interviews. But I think there are some people that feel like they need to go on lots of interviews. And there's an entire issue with making sure that there are enough interviews
for everybody. Now, because that barrier of, you know, the geographic barrier, and then scheduling yourself, you know, now you can do almost two programs in one day, which some people are actually trying to do for our interview day. And I'm fine with that. I think it's I think it's a good use of the resources. But you know, it comes with its own issues of making sure there's enough access to slots for all applicants.
different directions. I love this conversation, it gets to some equity issues, are we truly giving all applicants the same access if the price tag is going to be so much? And I think that's, that's a legitimate, a legitimate concern.
Yeah, and I think in an ideal world, you would not have the cost barrier for applicants with you know, traveling. And I agree that residency is such an important thing. You're going to spend five years somewhere, at least in the US to learn your craft that, you know, you really do have to get a sense of the city, the environment, the culture, and I think that you know, for a fellowship program like ours, it's one year. It is really nice, I think to have people see
what we have here. To see the culture to kind of feel the interactions that we have with each other as partners, because I do think that is, personally, a strength of our fellowship, that we have people that are, you know, really kind of with their own clinical interests. But really, as a group, we come together and we work together well, and I've been in places where the faculty don't always work together well. And I think that is one of our strengths.
So, you know, maybe, you know, not having in person interviews, you know, hurts us a little bit in that regard.
I agree with what you say. We show well, or at least I think we do, you know, we have impressive facilities. And I do think we have the camaraderie and things like that aren't always apparent if the relationships aren't good. So it can't you know, the the curtain can be difficult to draw back for an applicant. Now, what I mean by that is an applicant's job is to assess all
factors. And really try to see beyond the show, because everyone puts on a show, it's harder to put on a show via zoom, compared to an in person interview, but their job is to see beyond that and try to understand if a show is being put on and what's not real. And I I think I take great pride in saying, we really don't put on a show. And we try to just to show who, we try to demonstrate who
we are and how we do things. And I think you're right, it is a negative that we don't get the opportunity to in person interview everyone. But again, we're making the best of a tough situation.
Yeah, I mean, I mean, to that extent, as much as I believe too that we have a great place, we don't put on a show, we just purely, you know, demonstrate what we have here. As you know, somebody who's gonna be more involved with the fellowship going forward, we also don't want to just rest on our laurels as a program that has had, you know, a good
Fellowship in the past. And I think that we've tried to take some steps to actively engage with applicants this year, and perhaps applicants from coming years to show them about our program, because, you know, like, you're saying, maybe there is a legacy from some of the changes in pandemic, pandemic
related changes in practice. You know, we're doing these information sessions on the coming Saturdays, where we just kind of say, hey, come hang out with us in a Zoom Room, ask us whatever you want to ask us, whether it's about the fellowship or not, I don't know if that's gonna be an effort, you know, that completely falls
flat and misses the mark. But I know that Marty and I are going to be in a Zoom Room this Saturday, and this will have, this episode will drop the day after the the first zoom one, but we do have ones coming up where you, you and David I believe are gonna be in a Zoom Room. Are you? Is it you and Calfee?
Me and Clafee.
Yeah, so you and Ryan, are going to be in a Zoom Room, and then David and Linda are going to be in a Zoom Room, and our fellows will be too, and I hope people attend. Maybe it's just alumni who want to come hang out. But we're gonna try.
Well, I think it's the right thing to do. All we can, you know, it is interesting. So resources matter, I would say that resources matter in multiple different ways. So, you know, as an applicant, to residency or to fellowship or, or to, you know, we don't want to not reference, you know, our occupational therapists, you know, resources matter, for training programs,
for the job you take. And so understanding those resources, and as much as we want to be pure and are taking care of patients, you know, you have to understand the world around you, and that finances matter. And so the ability to have a great interview day in person is is something that gives you information about a program or about a job. The ability to pivot, as we have done is also important, I think everyone can
pivot to zoom interviews. But not every program is going to put together a slick video, and not every program can show what they have online as easily as others. Does that mean that's the program for you to train at? Of course not. But it just the more information that you can glean from a website, the better informed you will be as an applicant. And so I think this really doubles down on the importance of what is available electronically for the applicant to consider.
You look really good in that video, Chuck. The video that we made, you look good, you look good.
I need some training on how to look on video.
Why do you want to train at WashU? We got everything you want. I love it. It was great. It was inspiring. I want to go to WashU.
You're too kind. You're too kind. Yeah, those things are fun to do. And I and again, we're we really and this may sound cheesy, it may sound non genuine, but I just I think our goals are simple. Share what we have because we believe we have it all.
But I think that in a way, you know the fellowship process going virtual may actually level the playing field a bit. You know, even if you don't have a fancy video, if you're scrappy, and you put together the information that you think applicants are going to want to see. And you are you can connect with what a virtual you know, fellowship or residency applicant is looking for. That's great, because if you know you don't need, you know, a big budget to put together something
informational. I mean, I remember before we got that professional video made, we had, you know, I zoomed with a group of, you know, former fellows over, you know, a series of nights and just, you know, slapped together a video, and it was really fun to do. And I think it's really informational. So I think in a good way, it's going to allow some programs that have great people and perhaps don't have the big budgets to show what they got.
I think that is well said. You can have the glossy videos, which actually may be less informative, but anyone who puts the time and effort can really provide great information for applicants. And I think what you said about laying the, the leveling the playing field is accurate. And here's how I think about that. So there are clearly top tier residencies and fellowships. And those are the programs that are
widely considered the best. But we all know that the best, quote unquote, you can't see me doing that. But the best for applicant A does not mean it's the best for applicant B. And there are quirks in the hand, in the hand world there are quirks about how much Plexus Do you get or how much congenital do you get? How much do you want? How much arthroscopy and so there are different flavors to different
programs. And the benefit of the zoom world is that the applicants can, without cost or significant costs, and without as many scheduling challenges, can see more programs. So those programs that may not be quote unquote, the best can garner more interviews and potentially offer you know, a really good opportunity to applicants who may not have been able to fly to that city and do an in person interview.
Yeah, there are a lot of fantastic Dark Horse kind of programs out there that I think we'll we'll see arise and perhaps quality applicants looking their way. You know, I think I think that's a good thing. You know, so I guess from if you were an applicant now, how would you approach this? So you know, knowing what you know, as a faculty member, and as somebody who's interviewing. How does an applicant come across
well, in a virtual format? You know, you can go from a high level, or you can even talk about nuts and bolts, logistics.
Yah some of the things that are universally applicable to an interview, or perhaps even more important, energy level, projecting well on camera, which means you know, what you're wearing. And it's not about exactly what you're wearing. It's about general how you carry yourself and your appearance, but look professional. I laugh about this, your Zoom background matters. Again, not everyone should have some fancy background, but just a clean
background. And perhaps you put a little something in that background to tease the interviews, interviewer's interest. And I've seen-
Did you bite on any of the background stuff?
For sure I do. All the time.
What do you might on?
Well, I don't want to say too much. So one of the applicants, very impressively, played college football at a major program. And it wasn't subtle.
Way to break the orthopedic stereotype.
It wasn't subtle, but there was a football helmet in the background. So you can be a little more subtle than that. But again, it's just about clean, perhaps a little informative. That stuff matters. But I think really, when you get to the heart of the interview,
I want to see what your, what your Pinterest board looks like.
It will tell you a little bit about me, I don't have a Pinterest board. So, it's energy level and I would say the curiosity and the preparedness really become more important. And so it's you know, having questions and some people say okay, I'll write down a list of questions, but having the right question for the right interviewer matters. And so if you're interviewing with the chief or the chair, you may may ask one set of questions versus someone else, I think that's really telling.
Yeah, I mean, I think the principles of it you know, connecting over an interview and conducting yourself in the right way that doesn't change we talked in the last time, last year about energy and energy is critical. You know, because if you if you can bring it for 10 minutes 20 minutes in an
interview, great. If you fall flat, we realize that, we rec- because we're doing these back to back too and it's certainly you know, not to downplay the stakes of it for the applicant but you know, it can be a long day on the interviewer side too. And we're going to remember if you come across flat so bring your questions, prepare, do your homework just like you would for
an in person interview. You know, people always joke about the zoo mullet, you know, business attire, you know, on top and then you know, gym shorts on the bottom. But I will say if you come prepared and you dress like you would for a normal interview, there's a bit of a persona that you feel When you're when you're dressed up for the occasion, so you know, take that with a grain of salt, make sure that you've got, you know, you know, a water close by in case you need to clear your
throat, something like that. But I really don't think that it changes that much. And obviously, and I'm victim I, I fall victim to this all the time, as listeners know, have a good internet connection because that can really make a difference. You don't want anybody struggling to hear you. So as much as you can, you know, try to be at a place with a consistent internet connection
hardwired in if possible. I know that not everybody has access to great Wi Fi so that, you know, that may make a difference.
I think you hit on all the important points, I would echo and emphasize the homework part more than ever doing your homework about each program matters. Well, of course, it matters, should matter to the applicant, so the applicant can really understand the program that he or she is interviewing at. But it also gives us an understanding of how seriously you're taking this interview and how interested you may be.
Have there been any and not to get into too many specifics? Have there been any major zoom fumbles or bloopers that that have come across your way? so far?
None? Honestly, I haven't seen a one I haven't. No, you?
No and I think that that actually, it comes to one of the points that you sort of mentioned earlier is that this is a program's opportunity to to give an impression. And what washu I think has always done well, I remember this from when I interviewed for residency and fellowship and faculty is that they they put on a very organized kind of show, and it is on time. And it is, you know, there are no glitches. And then I saw that in the residency interview, they did an
incredible job. And I know that you know, Emily, who does our fellowship interviews is gonna be working hard on the logistics. But I remember, you know, when I was interviewing in person for fellowships, there were some places where I sat in a room for four hours, and nobody talked to me. And I was just saying did, do they remember, I'm here, like, what what's going on? And that obviously doesn't leave the best
impression. So I'm sure programs are, you know, are are on to that and the importance of that. But just like applicants can leave an impression on us. You know, we leave impressions on applicants if we don't come across professionally.
I think that's absolutely right. And you are also correct. I think our programs have done a really nice job of, you know, pivoting as we said, but really demonstrating our attention to detail with how we have conducted our interviews, which fits our personality. I mean, we're not a laid back department. We are focused on doing well, the important stuff. And this is important to us. And I think it is reflected in how we handle our interviews.
Well, I guess we're coming to a close now, I did want to give a little promotion to the Ask me anything sessions, maybe Chuck we can put some links in the show notes. You know, the after this episode drops on Saturday, January 30. Our fellows are going to be doing a session 10 o'clock eastern time. And then the following Saturday, February 6, it's going to be let's see here, Dr. Wall and Dr. Brogan that
should be a fun group. And then the following Saturday it is Dr. Calfee and Dr. Goldfarb, and congratulations to Ryan Calfee, the new chief of the hand service of washu. I know that Chuck, you probably have been excited to hand the reins over for, to Ryan.
Well, you know, Ryan is, is a wonderful partner. He's a contributor in a major way to hand surgery through the ASSH, through his role as deputy editor of the Journal of hand surgery. He really wears many hats already. And this is well deserved. And you know, I think one of our principles here is we want to recognize talent and ability and accomplishment. And Marty Boyer and I did not, do not need to continue to be Division Chief. We're not checking out in any
way, we'll be involved. But I think it recognizes who Ryan is and what he's done. And so I'm very happy, I guess, a little bit proud of this transition.
Well, congrats to Ryan. And speaking of wearing many hats, you've got a bouffant on so it looks like you're going back to work. So I will let you enjoy the rest of the rest of your day. And thanks, everybody for listening.
Hey, Chris, that was fun. Let's do it again real soon.
Sounds good. Well, be sure to check us out on Twitter @handpodcast. Hey, Chuck, what's your Twitter handle?
Mine is @congenitalhand. What about you?
Mine is @ChrisDyMD spelled d y. And if you'd like to email us, you can reach us at handpodcast@gmail.com.
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Special thanks to Peter Martin for the amazing music. And remember, keep the upper hand. Come back next time.