||Surgical Critical Care/Trauma
||The Baylor College of Medicine Surgical Critical Care Program’s mission is to provide Residents with a broad-based education in all phases of Surgical Critical Care and allow Residents to develop advanced proficiency in the management of critically ill surgical patients specifically as they relate to hemodynamic instability, multiple organ failure and complex co-existing medical problems; to develop the qualifications necessary to supervise a Surgical Critical Care unit; and to conduct scholarly activities in Surgical Critical Care.
This is accomplished through a large and diverse patient population in three affiliated hospitals, the Texas Medical Center facilities, a diverse faculty and unique experiences in research and technology development available at Baylor College of Medicine. Each affiliated hospital, Michael E. DeBakey Veterans Affairs Medical Center Surgical Intensive Care Unit (SICU), Ben Taub Hospital Trauma Surgical Intensive Care Unit (TSICU) and Texas Children’s Hospital Pediatric Intensive Care Unit (PICU), has extensive clinical volume to provide the critical care resident enough experience to attain proficiency in the management of the severely ill surgical adult and pediatric patients. In addition, at each facility, the Surgical Critical Care Resident will assume supervisory and administrative roles in each ICU under supervision and mentorship of each of the assigned faculty.
The length of the educational program is 12 months, one month of which will be an elective rotation, with time allocated to each of the surgical intensive care units. The monthly schedule has two of the three resident’s rotations through the MEDVAMC SICU for six months, Ben Taub Hospital TSICU for five months and Texas Children’s Hospital PICU for one month. The Pediatric Critical Care Resident will follow a more rigorous schedule at Texas Children’s, rotating in the PICU for four months, the NICU for three months, CVICU for one month, Burn Unit for one month, and then rotating at Ben Taub Hospital TSICU for three months.
The Trauma & Surgical ICU at BTGH is a 30 bed intensive care unit that admits patients > 16 years of age. The majority of the patients admitted to the TSICU are trauma and emergency general surgery patients but also include vascular, surgical oncology, urology, orthopedics, ENT, OB-GYN and OMFS patients. The TSICU service follows all patients on the trauma and general surgery services admitted to the TSICU and acts as a consultant service. The TSICU team is led by a board certified Surgical Critical Care specialist. All TSICU attending physicians are on faculty at Baylor College of Medicine. The team consists of a board certified critical care attending (either surgery or anesthesia), a critical care fellow, a PGY-2 day resident, a night resident The team may also include 3rd and 4th year medical students. The critical care fellow is expected to perform as a junior attending
The MEDVAMC is the largest tertiary referral center in the VA system. The 20 bed surgical ICU houses patients from general surgery, vascular surgery, ENT, neurosurgery, transplant surgery, urologic surgery, OMFS, plastic surgery and cardiothoracic surgery. Excluding cardiothoracic patients, the ICU is a closed unit with the SICU team co-managing all patients. The SICU team is led by a board certified Surgical Critical Care specialist. All SICU attending physicians are on faculty at Baylor College of Medicine. The majority of our patients are elderly with complex cardiac, pulmonary, renal, hepatic, & social histories. The rotation at the VA allows for potential elective time with interventional radiology and CT anesthesia to obtain proficiency with TEEs, SG catheters, & intubations. There is also some exposure to ECMO initiation. Educational components of the rotation include BCM-wide quarterly journal club, annual US course, Sim Lab for mock codes, & weekly fellow-led lectures for junior residents.
The Pediatric Intensive Care Unit at TCH is a 31 bed unit which includes a mixture of surgical, medical and trauma patients. It is one of the largest PICUs in the country and is almost always filled to maximum capacity. Patients are divided into three pods, and during this one month rotation for the adult track resident and 2 month rotation for the pediatric track resident, the resident will be assigned to one of the pods, which houses approximately 10 patients. The pod is led by a pediatric intensivist and the team consists of PICU fellows, PICU nurse practitioners, and pediatric residents. The SCC residents will be primary responsible for 2-3 patients in this pod, but they will also have the opportunity to participate in the care of pediatric trauma patients housed in the other pods as well as patients on ECMO.
Baylor’s Surgical Critical Care Residency is accredited by the ACGME and adheres to all policies and requirements of the accrediting body.