||East Carolina University/Vidant Medical Center (VMC) offers both ACGME accredited Surgical Critical Care and AAST accredited Acute Care Surgery fellowships. Training takes place at VMC, the 900-bed flagship tertiary care teaching hospital of East Carolina University. VMC is a state of North Carolina accredited, and American College of Surgeons verified, level I trauma center, and is one of the busiest tertiary care academic medical centers in the country. The trauma center at VMC admits approximately 2,800 patients annually, and the trauma and surgical intensive care unit evaluates over 1,500 patients annually. As the only tertiary care center serving the entirety of Eastern North Carolina and the Outer Banks, VMC is unique in its volume, breadth and complexity of trauma and surgical critical illness. Nine months of the SCC year take place in the 24-bed trauma/surgical ICU as well as the 8-bed neurosurgical ICU. Electives are available in pediatric, cardiothoracic, and medical critical care, as well as burns and trauma. Within ACGME guidelines, we make a concerted effort to get fellows into the operating room during the SCC year. The strengths of the SCC year are multiple, and include the volume and complexity of tertiary care surgical pathology encountered in a rural and underserved region. In addition, the fellowship offers graded autonomy, allowing fellows to "run" a multidisciplinary trauma and surgical intensive care unit. The true strength of the fellowship lies in the teaching faculty, 8 fellowship trained faculty, each having been formally recognized for teaching excellence. The unique feature of the ACS year relates to the lack of competing residents and fellows on the majority of rotations, including orthopedics and neurosurgery. Mandatory rotations include trauma, emergency general surgery, neurosurgery, orthopedic surgery, vascular and interventional surgery, as well as thoracic and hepatobiliary. Electives are available in burns, pediatric surgery, and transplant/urology. The year includes intensive experience in trauma and emergency general surgery, with fellows serving as the attending on those services, as well as a special focus on trauma systems and acute care surgery leadership. Research is an important component of both years, and fellows will have ample opportunity to contribute and publish. The division of acute care surgery has multiple ongoing projects, including AAST and WTA multi-institutional trials, basic science projects, as well as prospective clinical studies. Our division includes a funded research nurse and statistician. The clear and simple goal of our fellowships is to train the next generation of leaders in acute care surgery. Candidates may apply solely for the SCC or ACS years. Completion of the SCC year is required to enter the ACS fellowship. The application process includes submission of curriculum vitae and three letters of recommendation, one of which should be from the department chair or program director. Interviews are conducted from July 1st through September 15th. We participate in the National Resident Matching Program. For more information and to apply, please email the program director (email@example.com) or the program coordinator (firstname.lastname@example.org).