Development of hand surgery: education of hand surgeons.

An organized experience in the care of hand injuries and infections was not available until World War II, when military hand centers were established. Dr Sterling Bunnell was designated as a special civilian consultant to the Secretary of War. The surgeons in the military services during World War II became the nucleus of the American Society for Surgery of the Hand (ASSH). Following World War II and the Korean War there was a major shift toward medical subspecialization, and the growth of surgery of the hand as a subspecialty parallels that trend. The ASSH initiated a coordinated effort to improve the educational experience, and in 1967 the ASSH Resident Training Committee was evaluating hand training programs. The ASSH developed a comprehensive program in continuing medical education, and received full accreditation from the American Medical Association Council on Medical Education. The American Medical Association has included hand surgery on its list of designated specialties since 1975. In 1973, the bylaws of the American Board of Medical Specialties were revised to provide special certification. The ASSH developed a proposal for a certificate of added qualification in surgery of the hand that was presented to the three primary boards (orthopaedic, plastic, surgery) and the ad hoc joint Committee on Surgery of the Hand was organized in 1982. An application for a certificate of added qualification in surgery was developed by the Joint Committee on Surgery of the Hand and approved by all three boards in 1985 and the ABMS in 1986. The first examination for the certificate of added qualification in surgery was held in 1989.