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Clinical Opportunities at Virtual Hand to Shoulder Fellowship

By: Mirella Deisher, OTD, MS, OTR/L, CHT

Virtual Hand to Shoulder Fellowship, LLC

Founder & Faculty




I became an occupational therapist 23 years ago, and from the start, I knew that hand therapy was what I wanted to do. I loved how scientific and methodical it was, I loved the complexity of the decision-making, and I loved the challenge of balancing out the patient's medical needs with their expressed goals.


Obtaining our professional licensure is just the beginning of a long journey to achieving competency and eventual mastery of our chosen specialty. Through the years, I’ve made regular pivots to invite the opportunity for continued professional growth and development, and I find myself, yet again, making another pivot.


For the last year and a half, I’ve had the privilege and opportunity to be part of the founding faculty of a developing doctoral OT program. I wanted to understand why and how our educations leave an apparent gap in our ability to effectively transition into the specialty of hand therapy, and I wanted to learn how to best fill it. Now armed with some insights of how our curriculums are designed, and with an understanding of how learning and the ability to think critically develops, I’m pivoting back to put my full attention on a program that is intended to not only fill a knowledge gap, but to support the attainment of clinical excellence in the realm of hand therapy.


This knowledge gap was an anecdotal observation based on my experience as a new grad working in hand therapy. At that time, I tried to remediate my lack of readiness by completing a physical therapy certificate program in upper quarter and hand therapy. I was fortunate to have built my career off this strong foundation, but it was having the opportunity to work with hand surgeons that really catapulted my professional growth as they shared knowledge that helped me to connect the dots on a much higher level. I was very fortunate as most therapists don’t have these opportunities.


As the years passed, I transitioned to leadership roles and was tasked with hiring clinicians. Yet again, this awareness of the knowledge gap got my attention as I struggled to find clinicians that would be successful and effective in a busy orthopedic practice alongside hand surgeons. This is what ultimately led me to develop a hand therapy fellowship program back in 2013. It was an effective solution as I provided the needed didactic education alongside a clinical education. We successfully recruited needed staff through the fellowship, and through both didactic and experiential learning, the clinicians not only became autonomous but continued to effectively grow their expertise to achieve clinical excellence.


However, I knew there were many clinicians that were interested in doing a hand therapy fellowship but either they could not relocate, or they couldn't afford the reduction in pay that typically accompanies participating in these programs. Thus, I began to consider the possibilities of developing the Virtual Hand to Shoulder Fellowship. I had completed my doctoral degree remotely, so it seemed like a viable solution to fill what I perceived to be a big gap from our generalist level education to specialized practice.