The Upper Hand: Chuck & Chris Talk Hand Surgery

Chuck and Chris Talk Zoom Interviews

January 30, 2022 Chuck and Chris Season 3 Episode 3
The Upper Hand: Chuck & Chris Talk Hand Surgery
Chuck and Chris Talk Zoom Interviews
Show Notes Transcript

Season 3, Episode 3.  Chuck and Chris share thoughts regarding zoom interviews in 2022.  We discuss our opinions on the format and pearls for successful interviewing.  Let us know your thoughts.

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As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
theupperhandpodcast.wustl.edu.  And thanks to Eric Zhu, aspiring physician and podcast intern.

Charles Goldfarb:

Welcome to the upper hand, where Chuck and Chris talk hand surgery.

Chris Dy:

We are two hand surgeons at Washington University in St. Louis here to talk about all aspects of hand surgery from technical to personal.

Charles Goldfarb:

Thank you for subscribing wherever you get your podcasts.

Chris Dy:

And be sure to leave a review that helps us get the word out.

Charles Goldfarb:

Oh, hey, Chris.

Chris Dy:

Hey, Chuck, how are you?

Charles Goldfarb:

I'm doing really well. How are you?

Chris Dy:

I'm fine. I'm feeling, it's weird. I'm the only one on our service that's not doing anything clinically today, because it's, we're recording on a holiday.

Charles Goldfarb:

Yeah, we're definitely talking about you. I mean, we're like, pulling your weight. I mean, my gosh.

Chris Dy:

It's okay. January is a slow month, right?

Charles Goldfarb:

Yeah, I am with you. I'm usually in clinic today. And Wash U clinics are canceled. But the hospital is open. And Dr. Wall convinced me to do some combo cases all day. So it'd be fun. But I'm a little envious of you to be honest.

Chris Dy:

It's okay. MLK Day in the Dy household is the annual take down all the Christmas decorations day. And that's what it's turned into for us. So we've got some work to do today.

Charles Goldfarb:

Yeah, maybe not so envious.

Chris Dy:

So any interesting cases recently?

Charles Goldfarb:

Yeah, I had to have one, which I think is worth at least a brief discussion. It was a 65 year old lady who sustained a distal radius fracture seven or eight years ago. And she was doing great, had no issues. And then all of a sudden noted that she couldn't extend her thumb and came to see me I don't recall where her first surgery was done. And her hardware looked to be in reasonable condition. And she absolutely had an EPL rupture. So, you know, I think essentially, for a couple of reasons. You One would think that if these ruptures are going to happen, they're going to happen sooner rather than later. But we know that's not the case. Because intermittently, all of us see these really delayed ruptures in to she was really unhappy with the position of her thumb. I wonder whether if this happened to me, would I have the tendon transfer? Because retropulsion of the thumb might be important, but general function, I think it'd be good. She was really unhappy. And she articulated her unhappiness well, she just didn't like the fact that she had trouble getting her thumb out to grasp things and just didn't like the resting position. What have you heard from patients in these situations?

Chris Dy:

So in classic Goldfarb, manner two things so I, I agree that it is the timing is weird. I've seen more delayed ruptures on the flexure side, then the extensor side. And then the second one is that I've seen one patient who had an ultrasound confirmed EPL rupture, and was no, I'm good. Like, I don't even bother me like, I offered him a tendon transfer, and he has not come back. So I don't know if he wouldn't had it somewhere else. But he seemed very content with the function of his thumb.

Charles Goldfarb:

Yeah, I've seen the same I mean, I've had a few patients was a most of them wanted it fixed. And obviously, we enjoy doing that surgery, it's fun. And, you know, generally has a good outcome, although it's not normal. And I do stress that you have to over tension a little bit to start and if so, it's a really interesting process, do you so when I do this, I always take the plate out and what some might argue that you don't need to I don't necessarily explore where the screw may have caused a problem. And that I don't know maybe that speaks to my intellectual curiosity or lack of but in this case, I took out the plate I did the the eip the EPL transfer, and stop there. How do you how do you think about these or do you do it the same?

Chris Dy:

I think if I was concerned about the plate causing further issues, it would be a definite take out the plate situation but if the plate is well positioned to flexors aren't at risk, I probably would just end up offering a wide awake tendon transfer. And because I was awake, I wouldn't plan on taking the plate out although I know you can do the plate awake. Do you think doing it the tendon transfer awake adds anything to the tendon transfer?

Charles Goldfarb:

Well, it's a great question. To me the unknown remains unknown whether you do this in typical anaesthetic fashion or wide awake and that is retensioning the retracted EPL tendon slash muscle belly is going to take some time to equilibrate. And so, yes, you know, you can certainly do this awake and and you will feel better about it immediately. But I don't think it guarantees you a different outcome. Because the the newly applied tension on the EPL is going to loosen it over time.

Chris Dy:

And how do you how do you rehab these patients? How long do you mobilize the tendon transfer? And then, you know, what do you typically asking your therapy colleagues to help?

Charles Goldfarb:

So it's a great question. And I think I'm a little went beyond this. I feel like I'm not wimpy on some things. But I think I'm a little wimpy on this one. I tend to go four weeks or so a mobilized that is a surgical, you know, dressing slash splint and then a cast. But I have a pulvertaft weave, which I really feel good about. And I don't think there's any reason I couldn't start therapy at two weeks, I actually discussed that with this patient. And she was she wanted to take she didn't she wasn't comfortable with that. So we're gonna cast for four weeks and then start therapy. And then the first few weeks of therapy will be active motion, both directions, no passive flexion. And then once you get to about eight weeks kind of anything.

Chris Dy:

It sounds like you're just letting patients run your practice. She's making all your decisions for you.

Charles Goldfarb:

Yeah, I like it, you know, it's just easier on me.

Chris Dy:

The old shared decision making. It's not really shared. She's just calling the shots.

Charles Goldfarb:

She was that kind of patient.

Chris Dy:

I didn't realize you were practicing in New York City.

Charles Goldfarb:

Yeah, well, my gosh, isn't that the truth.

Chris Dy:

Well, it's so it's, it's a fun time of year, because we're getting into fellowship interview season. I know that there are some firms that have already done their interviews. And I thought it'd be good if we just talked about kind of approaches to this, because it's for at least hand surgery, it's virtual for a second year in a row, which I think most of us have figured out kind of how to do a good job at this. But you've also been participating in residency interviews, and I think you're doing the peds fellowship interviews virtually to I mean, what have been your experiences so far this year? And how has it been different from last year?

Charles Goldfarb:

Yeah, I mean, I think I have a lot of thoughts to share, we maybe we can just start general. And then we can dive in it. The first thing is, and I'm sure you feel the same way. This is hard. It's hard on applicants, even though we should talk about the advantages. And I do think those are real and should not be overlooked. But it's hard on applicants is hard on interviewers. It's hard to make a connection, which is more easily made in person. I get why we're doing it this way. And the decision in retrospect was the right one given omicron. You know, this decision was made six months ago, and it was the right one. So I think the challenge for everyone involved is creating a connection. And that's just not easy.

Chris Dy:

I'm trying to figure out how we can connect with applicants and how they can help connect with us. I mean, what have you found we maybe I'll talk about it from the applicant perspective. But can you talk about what what's worked for us in terms of the fellowship and the residency in terms of us getting across the screen and showing people who we are?

Charles Goldfarb:

Well, I like what you have done. And I like what the residency has done. And that is a couple of things. Number one, I think it this increases the importance of having a great web presence in general. So website and associated pages is incredibly important so that the interested resident or fellow applicant already has a sense of the program. And that that's a that's a real important message, I think is that we will pick up on whether the applicant has done his or her homework. I mean, let's be honest, that's what it is. But it is a job interview and your understanding of the program is important to convey not not in our face kind of way. But it's important to convey. But it's also important for you to have that baseline information. And so the webpage is important. And some of these pre interview day opportunities, I think are great because again, they get some of the mundane out of the way. So conversations that we might have over zoom over a quote unquote, cocktail hour. We've been doing those for all the specialties and I think honestly, Chris, it was you who started that have been really successful and effective. And just make just kind of dial it down a notch so that there's a better baseline understanding which facilitates better conversations during the interview.

Chris Dy:

Yeah, you know, we wrote a review article that was in JHS. I think it came out on kind of optimizing virtual interviews. So you know, Caroline Granger. went through that process for residency last year. So I asked her to lead it. And even looking at the literature that's out there, it's clear applicants are looking at websites more, they're relying on websites more and rightfully so which means us on the program side, we need to have good content, you know, that is having at them at a bare minimum, a serviceable and up to date website with, you know, information about the program, but then take it to the next level of, you know, here's why we love our program. Here's what's like to live in our city. Here's what our residents and fellows think. And I had a lot of fun recording alumni interviews last year, just kind of asking them about what made the program great, and then editing that down. It was a fun process. I think from an applicant side. One thing that I don't think enough people do ahead of time, they reflect on an after the interviews, but you know, what are you really looking for in a program? Like, what are your priorities? And, you know, I guess I'm old school, but writing it down, and saying, like, here are the things that I want to get out of my year of training for fellowship? And here are the things that are a little more flexible about what am i Non negotiables? What are the things that I can bend a little bit on? And how can I? How can I ask my questions and learn about this program to match those needs.

Charles Goldfarb:

Super important, especially in the Zoom era, because you have to be more direct, to get the information. And when I say you, the applicant needs to be more direct, to get the information that they need. And so let's be honest, there are a number of really good fellowships. And there are a large number where a fellow can have a great year and learn what they need to learn. But excellence in a fellowship varies based on the eye of the beholder, and what that fellow really wants. And there are differences at every tear of fellowship. And so you're right, you need to look yourself in the mirror as an applicant, and be honest about what is important to you. Whether that's how much call or you know how crazy intense it is, or micro or Plexus or congenital, be honest with what you want, or at least you think you want. And that helps you go into these interviews and interview season eyes wide open.

Chris Dy:

Yeah, I think one of the practical tips that I give residents as they're applying for him fellowships, at least is I think two ways that you can whittle down programs are do you want to do shoulder in your fellowship training? And then do you want to do to see peds in your fellowship training? Because we have some firms are very heavy on children, if you spend, you know, yes, some people say it's only a rotation or two, but is that as being a quarter of your fellowship, and then you go out and practice and you don't want to do any rotator cuffs, perhaps that time would have been better spent on learning other things. Now granted, there are principles you can learn from, you know, those cases that you can apply to any hand surgery or extremity practice. But I think that's one practical thing that I've advised our applicants to use in the past.

Charles Goldfarb:

It's great advice. It's absolutely relevant. What's so hard though, is that, you know, it's a rare applicant who has any clue where he or she is going to go into practice in their career, that would be ideal. If you knew you were going to X or Y job that had this expectation of you that would be great. Failing that, then a broad based education is helpful. I would think that the vast majority of jobs for hand fellows do not prioritize shoulder simply because shoulder and elbow surgeons and sports surgeons are in you know, good supply. And so there are exceptions that want an entire upper extremity surgeon typically smaller groups and and less congested areas. But I think your advice is good. Just like your advice is good about peds. I personally believe peds has more generalizable lessons. But But peds. Micro Plexus and shoulder are the areas that will not appeal to everyone.

Chris Dy:

Yeah, I think you probably think peds applies to everything. I mean, I can't. I'm trying to trying to think of a good story. So I could use my peds principles. But I think that one thing about even if you're not going to do you know say peds or Plexus or whatever, I think he's just being around people that are so into that into something like and have a passion for it. And you can learn lessons in that regard in terms of how to for example, if somebody comes here and doesn't want to do any Plexus, maybe they've learned something about you know, the way that David and I have set up the program and the research and everything, maybe there's something to learn from that. But I think that is you know, trying to get the most out of every experience. You talked a bit about, you know, the applicants looking in the mirror I think one of the steps that we take Took us a fellowship a couple of years ago was for us to look in the mirror and truly, proactively try to understand our, you know, our values, our goals as program and establish a vision. And I think that was a useful exercise for us as a group to go through to really say, Hey, who are we and then that helps us say, what kind of fellows do we want here?

Charles Goldfarb:

It was incredibly important. And, you know, the goal of this whole process is to really get a good match. You know, we don't want a fellow here who was deceived in some way, or who didn't understand who we are. And what we are about, we want to fail that is excited to be here, for sure, wants to make the most of a single year of additional training. And really just is, is kind of drinking through a firehose, because, you know, I believe that's what we have to offer. There's so much to learn in that one year, that we want the fellow to be all in on all aspects of it. And if they are, it's a great year for everybody. I mean, let's be honest, we, we hope to train future academicians, but more important than that is training great people that are going to do a great job and carried four principles they have learned or at least solidified and fellowship onto their practice.

Chris Dy:

Yeah, I mean, I think that when we, when we talk about, you know, the kind of fellows that we want to train here for at least our program, we were very interested in training leaders doesn't necessarily mean researchers, you know, people involved in societies, whatever, but leaders in their respective areas in terms of where they're practicing, you know, and I think that's been a big challenge for us. I think that you know, from an applicant perspective, or to give some advice to applicants, so not only look at yourselves in the mirror, but try to look at programs that truly understand who they are and who they want to be and who they want to train. Because I think having that clarity of vision, at least, if it comes across in the interview stage, that means that you're going to have a great year, if you end up there because they're organized. And I think that that's another thing that you know, from a program side was highly emphasized by applicants is the need for organization in the day. And I read a AAOS now article that was written by Charlie Wilson. So I know Charlie listens to the podcast. So hi, Charlie. He matched at Mayo for his fellowship in starting next year. And he went through the virtual interview process and gave some really great tips on kind of practical things from the applicant perspective, you know, like not waiting around in a room for a long time, condensing the schedule, and then also having enough time to really sit and talk unfiltered with with the current fellows.

Charles Goldfarb:

Yeah, those fellow conversations are critical, because you're going to get a fellow centric perspective. And we hope that that matches the attending view of the world, but didn't always and so I think that's important. The other thing, which I believe is really important, is how an applicant views mentorship, and us kind of how they might connect with future mentors. And that's just incredibly important. The hand world is small. The hand society and the annual meeting is pretty small. And these are the connections you make during your fellowship year with your co fellows which you cannot choose. But with your faculty, which you do choose, it's just so important. And really trying to see who you connect with as an applicant, who you are, who you might connect with, is is if not the most is certainly one of the most important things, at least from my perspective.

Chris Dy:

I don't know about you, I am. I remember a lot of people that we interview for fellowship, obviously, we don't match all of them. But I remember a lot of the conversations and you're like you're saying it's a very small world, you will see everybody again, and it's great to at least have made that initial connection. And I mean, I'm not saying to interview multiple programs just to network, but that's definitely a nice benefit.

Charles Goldfarb:

Yeah, and, and the, the, the opposite is true, it's a bummer of a loss, not to be able to see the fellowships in person and see kind of the environment because you do get more of a sense without a doubt of kind of how programs work when you're, you know, in the office and, and in the home environment. But but you know, what it is what it is, and we have all had to make the best of it.

Chris Dy:

So it's interesting. You know, I think that when we present it or we have this article danno say contributed he gave us some data that was presented at the hand fellowships directors meeting at in October at the hand society and they when they issued a survey about virtual interviews after last year cycle 80% of applicants said that they would prefer staying virtual, you know, because I think it gives them Way more than are some nice advantages for the applicant especially cost, which is mean, applying to fellowships is crazy expensive with all the travel. So that's that's big and I think that maybe perhaps a app, there's nothing that stops an applicant from doing a look at the city on their own, you know, outside of the formal fellowship, you know, interview. So if you're curious about what it's like to live in, you know, a certain place, just go check it out, if you can, you know, obviously COVID permitting.

Charles Goldfarb:

Good points. I mean, there's so much to learn virtually, about a city about an institution, obviously, about a training program. You're right. I mean, maybe this is here to stay, you know, it's easier for a fellowship, because it's just one year, residency, being five years does sort of increase the magnitude of the decision for virtual interviews. But I look, I don't know that this is wrong for the future. It'll be very interesting to see what happens with this process. What should we talk through what you how you think, like, practical tips on the actual interview?

Chris Dy:

Yeah, I was actually where I was gonna go next. I mean, I think that, you know, the practical things from the applicant perspective, you know, this sounds silly, but treat a virtual interview, like a regular interview, like an in person interview. So, you know, however you prepare yourself for that, you know, the easy one to say, is to wear pants. But, you know, clearly prepare yourself as if you were doing an in person interview, get yourself in that zone. Now, I guess, you know, perhaps everybody's feeling a little, a little too comfortable on Zoom stuff, but you really got to, you know, present the right energy. There are practical things like making sure that your lighting is set up appropriately, checking all your AV stuff, and your internet connection, because while it shouldn't, those little technical hiccups will affect the, you know, the interview itself, and how people perceive the experience on both sides. So for example, if we're running behind on our schedule, that's gonna take off a lot of people and not reflect well on us. Or, but if you know, you have a, you know, an internet connection that keeps cutting in and out on an applicant side, that's not going to help them.

Charles Goldfarb:

I think that's really well said. And actually, while neither, if you're watching us on YouTube, you can appreciate this. My lighting right now is terrible. I have kind of yellow light. I now, if this was an interview, I would have different lighting, lighting matters. Sound matters, your background matters. And we can try to overlook those things. But we're humans, right? And we're gonna be interviewing a large number of people. And when someone pops when when you have them on the screen, you just start off at a different level, as opposed to if someone is dark and hard to hear and crappy background, then you start off at a different level. Yeah, you can make it up or, or you can lose the advantage either way. But, though, get those basics, right.

Chris Dy:

Yeah, there are a lot of resources, just in the general kind of lay literature about you know, how to present yourself well on a virtual interview. So and you don't have to get anything super expensive. It's just about where you position yourself and how you have the lighting and all that kind of stuff. So, yes, sounds silly. But those things do make a difference. Do you have any tips on the actual interview itself?

Charles Goldfarb:

I do. Like the stupid stuff, such as lighting, energy matters. And it matters more in a virtual interview to me. Because just the, it's harder to make an impression over a computer screen than it is in person. And so, you know, you have to not go crazy with over the top. But you have to bring energy and some type of dynamic interaction. When you do the interview. You have to and it's not in everyone's DNA to do that. But being upbeat, being ready to ask questions when you have a chance to, you know, this, you know, kind of engaging leaning forward rather than leaning back and kicking your feet up. I mean, those things are just that the nonverbal cues tell us a lot. And we try to do the same thing. And so those things matter as well.

Chris Dy:

Yeah, I think that, um, you know, one, one tip, that's super important, it again, seems kind of routine, but practice, practice, practice, practice, especially, it's so easy to practice now with virtual interviews. I mean, get anybody on the Zoom. But do some mock interviews because you want your there there are questions that you should you know, you're going to be asked like, why do you want to be a hand surgeon that's at least going to come up one time during your interview? And you need to have a an answer that is It's rehearsed to the point where it no longer sounds rehearsed. You know, because you have this kind of inflection point where after a while, it's like, okay, you got it down to sound like you're giving a speech. But then after you've answered it a few more times, then it's just genuine. And I think that you know, for there are certain number of questions you're going to be asked throughout the process. As long as you have really answered those questions a number of times and practice them, they're going to come across really well.

Charles Goldfarb:

This, this process should cause healthy introspection and self reflection. It's a good thing. It's a good thing for all of us. And having processed the likely questions in advance can only help you. And as Chris said, I could not agree more interviews, skills can be obtained through practice, without a doubt, and it's just repetition. I'll say the other thing is, this can sound weird. The answer doesn't always matter what you verbalize, of course it matters. But if you get thrown a question out of left field, and you are totally thrown off, if you hem and haw, and you stutter, and you and you just can't get an answer out. That's, that's not good. But if you get an answer out of this, at least somewhat reasonable, that's okay. Because we don't often remember unless you say something outlandish, or do something outlandish, kind of the intermediate answers don't really faze at least me. So I think be prepared, in a general sense, and give a politician's answer sometimes if you can't give a better answer.

Chris Dy:

So I think that, you know, in addition to, you know, things that applicants can work on, and I think us on the program side, we need to be better about the questions we ask, especially in the 10 minute interview, you can chew up all the time just kind of saying, Well, you know, this person at that place, let's talk about that person like that. That's been the temptation cuz that's the easier thing to do. And I'm going to try this year, again, for us to use standardized questions. But this year trying to have the standardized questions really reflect the values that we're looking for, in our, in our program and in our applicants, the people that we want here, because I think that we have such a small amount of time to try to understand and get to know somebody that we wasted by just saying, Look, you got any questions. And that honestly, that's one thing that will take off an applicant is that if we haven't read their application, we don't know them. We don't try to get to know them in the interview. And we just take the easy way out.

Charles Goldfarb:

Really well said, it's always been a curiosity to me. And it's and I don't want to say frustration, although it should be probably, that if there are 6 10 minute interviews, they shouldn't all go exactly the same way. Because then it's just what's the point? And so I like when there are some there's a focus, or a particular question, that one interview room will ask information to be gleaned from me versus you versus others. I think that's really important. And you know, we will be prepared and we will all have read every application more than once. It's just a learning and it's a familiarity, familiarity process. But really, I like your point a lot.

Chris Dy:

So as we draw things to a bit of a close, is there anything that that you think programs should be doing that we're not doing now to kind of push us forward and help us interview better.

Charles Goldfarb:

It's what you what you just mentioned, it's it's not just setting up interviews and telling the faculty go get them and, and, you know, meet all these applicants and make your list. It's far more than that it is an organ it is a more complex organization about what we need to learn to give us the best chance of having the best fit. And so preparation and real thought on the on the on our side is critical.

Chris Dy:

Can I ask one one silly question? Which I know you're I don't nobody has a perfect answer for this. How can an applicant show that they've done their homework without putting it in your face? Because then you know you inevitably will have you know applicant says hello Dr. Goldfarb I read your 80 million papers on so and so. You know, so how do you have the right amount of it? Show that you did your homework ask insightful questions without totally fanboying over Chuck Goldfarb.

Charles Goldfarb:

Fan fanboying is okay, no, I'm just kidding. It's it's not not nothing makes me less comfortable than that. It's it's-

Chris Dy:

Yeah I know you still you still won't sign my book.

Charles Goldfarb:

If you have a question, if you have an opportunity to ask a question to me, that's the best way so if I were interviewing with you, I might ask a Dr. Dy when I'm doing a nerve, or I might I'm doing a plexus with you and we bring The microscope and how do you think about teaching me to be as successful as you are, you know, it's maybe that's even too much, but it's it just it doesn't have to be in depth. It doesn't have to be in 1999 You wrote your first paper. That's crazy, but it just needs to reflect a general sense of who we are. If you get too specific, it gets awkward, I think.

Chris Dy:

Yeah, it's probably about right. So, um, you know, I will shameless plug here. I really liked the virtual interview article that we wrote. It's it's available I think it's actually online for free might be free on the JHS website. I thought it was a it was fun for us to put together and I think it does have some useful tips. So as we are doing in this season, Chuck, why don't we close with either a win or a loss? We're adding the loss just because you know, you shared an L last time so.

Charles Goldfarb:

You go first this time.

Chris Dy:

I'm so predictable. Um, the things in my life are outside of hand surgery are hanging out with the family working out and cooking? Usually all in the same day? So I recently hit my 900th ride on the peloton, which was fun. And then I made an amazing cornbread focaccia. Yesterday, which I'm not a baker, but I we were having some people over and watching football and it felt like a nice thing to do. And I also made a soup, which I usually don't make soup. And it was it was a nice little lunch.

Charles Goldfarb:

Well, gosh, I think this is the first time I've heard football and cornbread focaccia mentioned in the same sentence.

Chris Dy:

Yeah, it's total total. Yeah, it's not wings and nachos. Because we had that the day before I wanted to do something a little bit lighter.

Charles Goldfarb:

This is an upscale invitation only event clearly.

Chris Dy:

We're all well, we're we're only hanging out with one family. So yes, it's an invitation only.

Charles Goldfarb:

All right, here's my win. Here's my win. We are gonna save this on. Oh, can I say this, we are trying to do a better and more comprehensive job as a department and as a hand division with organized rounds. In the past rounds have been somewhat haphazard, sometimes really haphazard.

Chris Dy:

Meaning non existent.

Charles Goldfarb:

I didn't say that. But we're trying to do better. So on Saturday morning in the snow, I came in, and had organised rounds with one of our junior residents. Michelle, she did a wonderful job. And it was actually in a weird way enjoyable. We, you know, it's like I it was old school, I felt like it was in medical school. And we rounded on it wasn't that many patients, six patients on different floors. And I was trying to be the good attending where I didn't have her pre round and then round with me and then post round and it ended up being cut out somewhere in the middle. But I liked it. It's weird to say I liked it.

Chris Dy:

I rounded the prior weekend. And you know, I got in there help change dressings. So we were just, you know, having a good old time, it definitely felt like it's been something I haven't engaged in as much since ending training. And look, we're fortunate enough to have a big group where you know, it's going to be I think we'll still view it with novelty.

Charles Goldfarb:

Yes, I hope we have this conversation in a year and you're still enjoying it.

Chris Dy:

Yes, exactly. So remember back then when Chuck and Chris enjoyed rounding. Anyway, enjoy your day of cases. I'm gonna go take down the Christmas tree.

Charles Goldfarb:

Have fun with that, too. Thank you.

Chris Dy:

Alright, see ya.

Charles Goldfarb:

Hey, Chris, that was fun. Let's do it again real soon.

Chris Dy:

Sounds good. Well, be sure to check us out on Twitter@handpodcast. Hey, Chuck, what's your Twitter handle?

Charles Goldfarb:

Mine is@congenitalhand. What about you?

Chris Dy:

Mine is @ChrisDyMD spelled dy. And if you'd like to email us, you can reach us at handpodcast@gmail.com.

Charles Goldfarb:

And remember, please subscribe. Wherever you get your podcast

Chris Dy:

And be sure to leave a review that helps us get the word out.

Charles Goldfarb:

Special thanks to Peter Martin for the amazing music. And remember, keep the upper hand come back next time.