A program proposal for an occupational therapy residency program in hand therapy was presented to the Physical Medicine and Rehabilitation Leadership Team at Mayo Clinic, Rochester. This program plan includes a manual detailing the yearlong program with expectations for the resident and mentor. This program will include didactic learnging, mentorship, and scholarly activities within the occupational therapy practice setting of hand therapy. The program will allow the resident to have interdisciplinary learning experiences with the orthopedic surgical fellows and residents through education sessions and observations in the surgical suite. This program will focus on anatomy, biomechanics, preparatory activities, orthotic fabrication, and occupation-based interventions for clients with upper extremity conditions. Official American Occupational Therapy Association documents will be referenced throughout the program to promote advanced clinical reasoning, ethical practice and support the Centennial Vision. At the completion of the program, the resident will demonstrate advanced clinical skills for common upper extremity conditions, evidence-based practice, and scholarship to promote the profession of occupational therapy.