Trauma Surgical Critical Care Fellowship

Program Director: William C. Chiu, MD

Program Coordinator: Dora Russell

Download Application here

Originally, a Trauma Fellowship, the program is considered by many to be the premier clinical trauma training program. The fellowship evolved into the Surgical Critical Care Fellowship in October 1993 when it was accredited by the Accreditation Council for Graduate Medical Education (the parent body of the Residency Review Committee in Surgery). The clinical experience is based to a large degree at the R Adams Cowley Shock Trauma Center. The goal of the fellowship is to produce academic leaders in the areas of critical care and trauma.

Under the guidance of a strong faculty, fellows master the cutting edge techniques of critical care medicine including new methods of mechanical ventilation and extracorporeal support of failing lungs, kidneys and hearts. The fellow will learn to manage the severely brain-injured patient, and the critically ill surgical patient. The global critical care management of the multiply-injured trauma patient is a focal point of their fellowship experience. Experience is gained in the management of single and multiple transplant recipients as well as patients after open-heart cardiac surgery. Additionally, the fellow will manage the full spectrum of surgical patients in a major urban medical center.

The fellowship is a one-year program involving patient care, research, and education. The program includes the following rotations: three months of trauma surgery, two months in the Neuro-trauma Critical Care Unit, and two months in the Multi-trauma Critical Care Unit at the R Adams Cowley Shock Trauma Center; two months in the Surgical ICU, and one month in the Cardiothoracic ICU at the University of Maryland Medical Center; and two months of elective. Electives are available in trauma radiology, trauma anesthesiology, trauma infectious diseases, transesophageal echocardiography, pediatric, medical and neurosurgical ICU as well as in the experience of Emergency Medical Services. All electives are arranged and approved with the fellow's future career goals in mind.

The fellows become proficient in the evaluation of critically-ill and injured patients; the initiation of appropriate and complete diagnostic and treatment plans; the development and implementation of patient care plans; providing leadership which facilitates the interaction within the entire team of caregivers and with the patients and their families. The fellow has full responsibility as trauma team leader, gaining a broad range of experience in the management of blunt and penetrating trauma, and the use of FAST (Focused Assessment with Sonography for Trauma). Administratively, the fellows are expected to grasp the art and science of trauma team administration and to achieve a working understanding of the major issues in trauma care such as, resource allocation, costs and ethical dilemmas. Upon the completion of this one-year fellowship, fellows will have acquired the necessary knowledge and experience to make them eligible to sit for the Added Qualifications in Critical Care exam given by the American Board of Surgery.

Fellows may opt to remain for a second fellowship year where they are provided opportunities for research through the R Adams Cowley Shock Trauma Center research program, as well as an opportunity to enroll in a Master's Degree program through an affiliation with the Injury Prevention Department at the Johns Hopkins School of Public Health. Emergency Medical Services (EMS) and pre-hospital research opportunities are available through the National Study Center for Trauma and EMS and in cooperation with Maryland Institute for Emergency Medical Services System (MIEMSS). Additionally, a second fellowship year is available to gain more intense training in trauma patient care and management.

Patient Care

Fellows are expected to become proficient in the pre-operative assessment, operative, and post-operative management of the trauma patient. Fellows are expected to become clinically proficient in:

  • overall patient assessment
  • ventilator management
  • techniques of vascular access and monitoring
  • direction of the trauma and critical care team

Fellows are expected to become familiar with the didactic knowledge required to adequately care for the critical care and trauma patient. They should be able to define and defend their management plans.

Education

Fellows are expected to:

  • Participate in the education of the rotating residents and medical students as well as evaluate their performance.
  • Present cases to the faculty and staff at a monthly formal Morbidity and Mortality conference. Additionally, the fellow is expected to present cases of interest to visiting Grand Rounds professors.
  • Attend monthly journal club meetings led by the faculty.
  • Attend weekly didactic sessions.
  • Certify, or renew their certification, in ATLS as well as in the ATOM course.
  • Participate in a course on moderate sedation and complete the requisite number of cases.
  • Complete a one-day course on the proper use of Focused Assessment with Sonography for Trauma.
  • Take MCKKAP, a critical care in-training examination.

Research

Fellows will be provided a research mentor from among the faculty. Research mentors are assigned based on mutual areas of interest. Near the end of the year, fellows will be provided the opportunity to present their research to the faculty.

Obtaining emergent consultation or transferring patients to the R Adams Cowley Shock Trauma Center takes only OneCall, day or night, to 1-800-373-4111 or 410-328-1234

This page was last updated: October 2, 2013

         
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