Daniel Guss, MD
Director, Foot & Ankle Fellowship Program
Department of Orthopaedic Surgery
Yawkey Building for Outpatient Care, Suite 3F
55 Fruit Street
Boston, MA 02114
Explore the Foot & Ankle Fellowship
Thank you for your interest in the Harvard Medical School/Massachusetts General Hospital Orthopaedic Foot and Ankle Fellowship program.
Our commitment is to help you develop into an accomplished orthopaedic foot and ankle surgeon - clinically insightful, technically capable across a wide range of surgical procedures, and a critical analyst of the latest research. We pride ourselves on the interdisciplinary care of each patient, working as a team with other surgical and medical specialties, as well as podiatrists, physical therapists, cast techs, medical assistants, research assistants and support staff.
The program offers three fellowship positions of one-year duration. Eligible fellows must have successfully graduated from an orthopaedic residency program. Fellows are credentialed at Massachusetts General Hospital (MGH), the flagship teaching hospital of Harvard Medical School, as well as Newton-Wellesley Hospital (NWH), a 300-bed community hospital in a nearby suburb.
The current fellowship is divided into two six-month blocks based on a mentorship model designed to foster lifelong friendships. You will spend six full months with Drs. Christopher DiGiovanni, Greg Waryasz, and Lorena Bejarano-Pineda, as well as an additional six months with Drs. John Kwon and Daniel Guss. This structure allows exposure to all staff while preserving a one-on-one relationship. Flexibility exists and fellows are enabled to adapt their schedule to attend unique cases or learning opportunities. Furthermore, exposure to all faculty year around is achieved through various didactic sessions, conferences, journal clubs, labs and other academic teaching sessions.
Fellows are credentialed at all hospitals and clinical sites as full attending physicians, with the goal of progressively nurturing a high degree of independence in both the operating room and clinic settings. Through an apprenticeship model with graduated autonomy, fellows are comfortable running their own foot and ankle clinic and are technically capable of independently operating on a spectrum of complex foot and ankle pathology by the end of their fellowship year. The opportunity to operate independently with immediate attending back up readily available, as a supplement to the expansive amount of time spent operating alongside an attending, is something past fellows have relished.
Fellows also run a longitudinal clinic that parallels clinics run by the attending staff. Fellows see their own patients one clinic day a week in order to foster independent decision-making, management strategies, and ownership of care. As always, attending staff are always readily available to answer questions and facilitate the care of patients.
Educational Program - Basic Curriculum
- General requirements: In accordance with the general teachings defined by the American Orthopaedic Foot & Ankle Society, our Fellowship program emphasizes professionalism, clinical competence and system-based practice.
- Professionalism: The fellow is expected to demonstrate respect, compassion, and integrity to their patients, fellow faculty, and staff. S/he is expected to be responsive to the needs of her/his patients and demonstrate commitment to excellence and on-going professional development.
- Clinical competence: The fellowship has been designed to develop advanced technical competence in the field of foot and ankle. Focus will be on advanced skills in the operating room, diagnostic competence in the clinic, and will foster analytic research excellence through our robust research program.
- Surgical experience: The fellow is scheduled in the operating room 3-4 days/week with an attending faculty member. The fellow will operate in the Main OR at both Mass General and NWH, as well as our Ambulatory Care Centers at MGH, NWH and Northshore Danvers.
- Outpatient experience: The fellow is scheduled in clinic 1-2 days/week, either independently or with a faculty member. The outpatient clinics allow the fellow the chance to follow patients s/he has operated on, to see new patients and devise management plans. The fellow has their "own patients" and are expected to manage all patient needs with input from faculty as necessary and with assistance from our administrative staff and physician extenders.
- Inpatient responsibilities: There are three fellows and one PGY-3 Harvard orthopaedic resident on service. The inpatient care is typically divided up by the service member who is on site at MGH for the day. There is a physician extender for floor coverage at both MGH and NWH hospitals who assist with daily management.
- Call responsibilities: Fellows may assist faculty who participate in call at various institutions based on clinical necessity and educational opportunity. There are no primary call responsibilities. Fellows will round on inpatient consults and bill when appropriate.
Educational Conferences and Teaching
- Multidisciplinary topic conference: Each Tuesday morning there is a multidisciplinary conference at the Foot & Ankle Center in Waltham. The fellow is expected to attend and be an active participant. The current structure is as follows: 1st week – indications conference/case presentations presented by the fellows and Faculty; 2nd week – multidisciplinary lecture; 3rd week - journal club lead by fellows and other disciplines; 4th/5th week – Faculty presentations. There are also several presentations by invited speakers throughout the year as well as periodic resident presentations.
- Indications conference: This weekly conference is held on each Monday or Tuesday. It is designed to review the indications for, and treatment options pertaining to, the surgical cases for the next 2 weeks. It is designed to be a very interactive discussion and is consistently highlighted by the Fellows as one of their best learning opportunities.
- Departmental conference: Each Thursday morning there is morbidity/mortality conference or grand rounds at MGH. Fellow attendance is expected. Fellows often present service cases at M&M conference and engage in multidisciplinary discussions with other orthopaedic surgery specialties.
- Research conference: There are weekly research meetings attended by members of the Foot & Ankle Research and Innovation Lab (FARIL), clinical faculty, national and international research fellows, residents, medical students, and other participating members of the FARIL community. These conferences occur Tuesday mornings at Mass General – Waltham.
- Conferences: We believe strongly that training outside of the hospital is an important part of the fellowship experience. Each fellow is allotted a $2,000 stipend to spend on educational conferences and/or other educational related expenses. Participation in local and national conferences is strongly encouraged.
- Salary and Benefits: alary is commensurate with that of a PGY-6 in our system. The salary for the 2019-2020 academic year is $80,000. Salaries are adjusted by 2-3% each year. Benefits include many competitive health, dental, and vision coverage options. Each fellow is allotted 3 weeks of vacation time to use for conferences, interviews, family time and other independent endeavors.
The Foot & Ankle Research and Innovation Lab (FARIL) opened January 1, 2019. FARIL is a groundbreaking initiative by the Mass General Foot & Ankle service focused on pioneering breakthroughs in foot and ankle research and innovation that will directly impact the care of the foot and ankle patients. Perhaps the most important quality of FARIL is its ability to integrate all aspects of Foot & Ankle care by incorporating every facet of research. From top institutions in the US to internationally recognized academia, FARIL researchers bring their diverse training and experience to create new tests and treatments. FARIL also brings together various organizations (MGH research institute, AOFAS) and industry leaders to implement new technology used to treat foot and ankle injuries. With patient care at its guiding focus, FARIL brings every component of foot and ankle research to one cutting-edge location.
Fellows are expected to complete two research projects throughout the academic year. By the end of the fellowship, you are expected to have two manuscripts prepared for presentation at the AOFAS meeting with the ultimate goal of publication. Multiple support staff are available to assist with initiation and completion of projects, including several international research fellows, research students, residents and statisticians.
Mass General Brigham Research Patient Data Registry (RPDR)
The RPDR gathers clinical data from several hospital systems at Partners Healthcare. (Enterprise Master Patient Index - EMPI, Hospital Decision Support System - EPSI (formerly TSI), Physician Billing System - IDX and EPIC, Longitudinal Medical Record - LMR, Corporate Provider Master - CPM, Clinical Data Repository - CDR, and Partners Personalized Medicine - PPM) and stores the data in one central data warehouse. Researchers can query this data by using an online query tool. The query tool returns aggregate totals of patient data that are populated with appropriately obfuscated, de-identified/encrypted data as per HIPPA privacy rules and the HHS Common Rule. With the proper IRB approval, researchers may access the patient’s detailed medical records for their specified cohorts of patients. The detailed medical records are returned to researchers in an encrypted Microsoft Access file and text (.txt) files. Detailed medical records may include the following types of data: Transfusion, Cardiology, Contact Information, Demographics, Diagnoses, Discharge Notes, Endoscopy, Laboratory Tests, PEAR Allergies, LMR Health Maintenance, LMR Medications, LMR Notes, LMR Problems, LMR Vital Signs, Medications, Microbiology, Operative Notes, Pathology Reports, Procedures, Providers, Pulmonary, Radiology Reports, Radiology Tests and Transfusion. Furthermore, images from hospital image repositories can be returned and viewed online.
Clinical Research Program Manager
Meet our Faculty
- Professor of Orthopaedic Surgery, Harvard Medical School
- Chief of the Foot & Ankle Service and Vice Chair, Academic Affairs
- Immediate Past President, American Orthopaedic Foot and Ankle Society
- Director, Foot & Ankle Fellowship Program
- Vice-Chair (Quality & Safety), Department of Orthopaedic Surgery, Newton-Wellesley Hospital
- Assistant Professor of Orthopaedic Surgery, Harvard Medical School
- Associate Chief, Foot & Ankle Service
- Foot & Ankle Orthopaedic Surgeon
- Associate Professor of Orthopaedic Surgery, Harvard Medical School
- Foot & Ankle Orthopaedic Surgeon
- Member of the Faculty, Harvard Medical School
- Director, Foot & Ankle Sports Medicine
- Foot & Ankle Orthopaedic Surgeon
- Instructor of Orthopaedic Surgery, Harvard Medical School