||Surgical Critical Care/Trauma
||Baylor University Medical Center (BUMC) is a 1,008-bed tertiary care hospital in the heart of Dallas with a high level of acuity and approximately 39,000 admissions a year. Since 1997, the American College of Surgeons has recognized BUMC as a Level 1 Trauma Center with approximately 2,400 admissions yearly. There are 123 total ICU beds, 57 of which are surgical ICU beds. Currently, our surgical critical care faculty provides care for trauma, acute care surgery, general surgery, solid organ transplant, heart and lung transplant, cardiothoracic, neurosurgery, orthopedic and orthopedic spinal surgery, ENT, oral surgery, OB-GYN, and plastic surgery. The surgeons in the Division of Trauma, Critical Care and Acute Care Surgery have always been closely involved in general surgery resident education (9 residents a year), as well as research and quality initiatives. Our surgeons also serve as Texas A & M Health Science Center College of Medicine faculty and are heavily involved in medical student education. The Division of Trauma, Critical Care and Acute Care Surgery continues to grow and currently includes 10 faculty physicians, 8 of whom are board certified with Added Qualifications in Surgical Critical Care.
The ACGME approved our new Surgical Critical Care Fellowship in March 2016 for four (4) fellowship positions. The goal of our Surgical Critical Care Fellowship program is to prepare the fellows to function as qualified practitioners at the advanced level of performance expected of Board-certified subspecialists. The fellowship will allow fellows to develop proficiency in the management of critically-ill and injured patients, develop necessary qualifications to supervise surgical critical care units, and to conduct scholarly activities in trauma/surgical critical care.
The 12-month fellowship is designed to provide surgical critical care fellows with an education in the principles and practice of state-of-the art trauma and surgical critical care according to medical knowledge and patient care, practice-based learning and improvement, systems-based practice, professionalism, and interpersonal and communication skills. This is accomplished by exposing the surgical critical care fellows to a broad array of surgical illnesses through didactic instruction in the basic and clinical sciences, as well as education during teaching rounds, primary patient care, educational conferences, and specialized rotations. Upon completion of training, the surgical critical care fellows are expected to integrate the acquired knowledge into the clinical situation to demonstrate proficiency in surgical critical care decision-making, specific organ system support, evaluation of new technology and treatment techniques, ICU administration, outcomes assessment, research design, and interaction with patients, families, and health care personnel. The Surgical Critical Care Fellowship will be individualized to each applicant and is focused on developing their future practices whether in academics or a private setting. The fellowship year is also customized to address specific deficits that the candidate feels that he/she might have with respect to operative, non-operative, and interventional management.
a. Surgical and Trauma ICU for 4 months
b. Cardiothoracic and Transplant Surgery ICU for 3 months
c. Neurosurgical/neurological ICU for 1 month
d. Cardiology for 2 weeks with focus on echocardiography
e. Anesthesia for 2 weeks with focus on difficult airway management
f. Medical Intensive Care Unit (MICU) for 1 month
g. Two elective months
During daytime hours, the fellows will participate according to the specifics of each rotation. For elective rotations, if there is a night call rotation already specified for rotators, then the fellow will participate according to the rotation call schedule. Every other weekend, participation in a 24-hour trauma and acute care surgery call with the surgical team is expected. We believe that operative experience is crucial in the training of the Surgical Critical Care specialist. We believe that operative experience is crucial in the training of the Surgical Critical Care specialist. Daily conferences for surgical critical care include journal club, process improvement and quality assurance meetings, and research and didactic lectures. Also, collegial interaction with the pulmonary critical care service and their fellows (2 per year) includes a weekly combined didactic lecture series that alternates between specialties. The fellows will participate in the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) along with an ASSEET and ATOM course, which are funded by the program.
Critical review of research is an integral requirement for the fellows. The fellows are expected to create two Practice Management Guidelines for Trauma topics and keep the current Guidelines up to date. Also, there are dedicated monthly research lectures, dedicated research meetings with research support staff. The fellows are expected to develop at least one research project and to be submitted as an abstract for presentation at a national-level conference and complete a manuscript for publication in a peer-reviewed journal. There are ample opportunities to accomplish this during the one-year fellowship. In 2015, the trauma division alone published seventeen manuscripts. We are currently seeking a full-time Ph.D.-level Director of Trauma Research. A budget is available for travel to a national conference for trauma or critical care.