Adult Reconstruction Fellowship Guidelines

Created by the American Association of Hip and Knee Surgeons (AAHKS)

and endorsed by The Hip Society (THS) and The Knee Society (TKS).

PDF of GuidelinesFellowship Match

The FOCAL Committee and FOCAL Webinars were created as a response to the COVID-19 pandemic and have continued to augment the learning experience for those in fellowship and residency through 2022. Through FOCAL, these young surgeons are able to join live lectures given by some of the country’s top adult reconstruction surgeons for free. View recordings. These webinars are not for CME.

Recognizing the need for a more structured fellowship education in adult reconstruction, the AAHKS FOCAL Committee created a Fellowship Guideline and a Suggested Curriculum for Adult Reconstruction Fellowship Programs which were approved for distribution. 

Adult Reconstruction Fellowship Guidelines

Approved March 2022 by the American Association of Hip and Knee Surgeons (AAHKS), The Hip Society (THS), and The Knee Society (TKS).  
The Associations provide these guidelines to fellowships that identify as Adult Reconstruction Fellowships and participate in the SF Match to improve the overall fellowship experience.

Guidelines for Adult Reconstruction Fellowship Programs:

1.  Provide fellows with a sound didactic and clinical education that is carefully planned and balanced with concerns for patient safety and fellow well-being. The learning objectives should not be compromised by excessive reliance on fellows to fulfill service obligations.

2.  Plan and monitor the relationship between residencies and fellowships to preserve educational experience of both.

3.  Provide an intellectual environment free of bias of gender, race, or religion that emphasizes acquiring the knowledge, skills, clinical judgment, and attitudes essential to the practice of the subspecialty.

4.  There should be a program director responsible for the program.

5.  There should be a sufficient number of faculty (minimum 1 full-time attending per 1 fellow).
     –  The faculty should devote sufficient time to the educational program to fulfill their supervisory and teaching responsibilities.

6.  An active research component should be offered in each program.
     –  These could include original research, local quality improvement projects, case studies, etc.

7.  A sufficient number of new and follow-up patients and procedures must be available to ensure adequate inpatient and outpatient experience for each fellow. 
     –  Minimum 250-300 primary TJA; 25 Revision TJA combination of hips & knees
     –  Combine surgical experience with clinical (inpatient and outpatient) to include preoperative evaluation and follow-up of surgical patients

8.  A Program Curriculum needs to be formulated and organized in each fellowship.
     –  Didactic Curriculum: regular teaching conferences (recommended weekly) should be organized on an annual schedule.
     –  Fellows should participate in the structure of the curriculum and present a portion of the lectures.  This curriculum should include:
              1) Rotating list of subjects with associated reading list and lectures
              2) Grand Rounds
              3) Morbidity and Mortality conferences
              4) Journal Club
     –  Programs are encouraged to use the AAHKS Curriculum Guide for topics.

9.  The faculty should evaluate the fellows whom they supervise in a timely manner on each rotation, no less than quarterly

10.  The performance of the faculty should be evaluated to include a review of their teaching abilities, commitment to the educational program, clinical knowledge, and scholarly activities. This evaluation should include annual confidential evaluations by fellows.

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