||Surgical Critical Care/Burns
||Summary: Surgical Critical Care Fellowship A. Program Demographics: 1. UT Southwestern Medical Center 2. Trauma/Acute Care Surgery 3. Mailing: 5323 Harry Hines Blvd., Dallas, TX 75390-9158 4. Physical: 5323 Harry Hines Blvd., Dallas, TX 75390-9158 5. Phone: 214-648-8870 6. Fax: 214-648-5477 7. Stephanie.firstname.lastname@example.org 8. Director: Christian Minshall, M.D., Ph.D 9. Coordinator: Kendra Armijo B. Introduction: 1. This is a one-year program that focuses instruction on the management of critically ill patients. 2. The majority of clinical experience, instruction and teaching will focus on the care of patients with critical illness. 3. The rotation will consist of twelve 1-month rotations that will expose the fellow to a wide variety of patients with significant pathophysiology. C. Resources: 1. Drs. Brett Arnoldo, Patricia Bergen, Alexander Eastman, John Hunt, Stephen Luk, Joseph Minei, Christian Minshall, Herb Phelan, Jose Sterling, Erwin Thal, Brian Williams, Ken Webb and Steven Wolf 2. Parkland Memorial Hospital is the main facilities used in this program. They will also train at University Hospital – St. Paul for the Thoracic Surgery rotation and Mother Trinity Francis Hospital in Tyler, Texas for the Vascular Surgery rotation. D. Clinical: 1. Core Rotations: 8 i. SICU: 3 months ii. Trauma/EGS: 3 months iii. Neuro-Critical Care: 1 month iv. Burn ICU: 1 month 2. Elective Rotations: 4 i. MICU ii. CCU iii. PICU iv. Thoracic Surgery Service: St. Paul v. Pulmonary Fibrosis/CHF Service: St. Paul vi. Vascular Surgery: Mother Trinity Francis (Tyler) vii. Research E. Call Responsibilities: 1. Call for the individual rotations are specified in the rotation guidelines. 2. Fellows are expected to comply with ACGME guidelines for work-hour restrictions and days off. 3. Fellows must notify attending back-up: i. When an adverse outcome or death is likely ii. When experience with a complex surgical process is limited iii. Consultant for vascular, thoracic or other subspecialty general surgery service is required iv. Multiple patients require surgery v. More than one Level I activation occurs F. Educational: 1. Fellow are expected to participate in all service specific conferences and seminars 2. Fellows are expected to attend all Divisional meetings 3. Fellows are expected to attend Trauma/EGS Morning Report except when not on service 4. Self Directed education and completion of appropriate reading 5. Pursuit appropriate ABS certification (or equivalent) 6. Fellows are expected to participate in administrative duties and hospital committees (see committee participation assignments) G. Administrative 1. Participation in ATLS 2. Participation in ATOM 3. Assist in the Tues/Thurs SICU Lectures 4. Update and review ICU book and protocols 5. Attend and Participate in SICU QI process 6. Attend and Participate in Trauma/EGS QI processes 7. Assist in the orientation and transition of the incoming first year fellows H. Administrative 1. Participation in ATLS 2. Participation in ATOM 3. Assist in the Tues/Thurs SICU Lectures 4. Update and review ICU book and protocols 5. Attend and Participate in SICU QI process 6. Attend and Participate in Trauma/EGS QI processes 7. Assist in the orientation and transition of the incoming first year fellows I. Research/Academic: 1. Apply for membership to ACS 2. Apply for membership to EAST 3. Attend one national meeting 4. Present at Grand Rounds 5. Complete one research project with national presentation including publication i. Identify a Mentor for project ii. Draft Research proposal (no more than 6 pages) 1. Background/Statement of Problem 2. Study Aims 3. Study Design 4. Presentation at Thursday Research meeting 6. Sit for the MCCKAP on-line exam in March (in-service) J. Professional Development Mentor 1. Identify senior faculty as mentor for second year (may remain the same as first year) 2. Fellow should meet at least quarterly to discuss progress, problems, career direction 3. Written summaries of meeting are to be sent to Dr. Minshall 4. Fellows will meet quarterly with faculty mentor and Dr. Minshall to discuss plans for future employment The Surgical Critical Care Fellowship provides an ideal model for the acquisition of skills and knowledge to fulfill the six core competencies. These specialty mandates that practitioners: 1. Achieve high levels of medical knowledge and surgical skills 2. Are adept at maneuvering within the hospital system and are oriented to collaborating with multiple groups of practitioners and specialties 3. Use evidence based medicine to drive patient care 4. Communicate very efficiently and effectively to families regarding critical illness and death and to multiple team members to ensure appropriate direction of care 5. Understand the benefit of PI/QA systems to achieve highest level of care for this very complex patient group and are capable of creating these systems to effectively evaluate patient care. The UT Southwestern/Parkland Memorial Hospital Trauma/Acute Care Surgery Fellowship assures that fellows achieve core competencies through a highly integrated and intense program. 1. Fellows attain medical knowledge in a “hands-on” atmosphere in primarily directing the EGS/Trauma teams as junior faculty and participating in other “off-service” rotations. Direct communication with the back-up faculty is strongly encouraged and viewed as essential for complex patient management. 2. Communication skills are developed, enhanced, and evaluated via numerous mechanisms. ATLS, participation in the direction of trauma resuscitations with weekly review of these resuscitations in QI as well as in Trauma conference, direction of critical resuscitation efforts with faculty evaluation in the ICUs, direction of OR teams, communication with numerous medical teams, communication with 100s of families with critically ill family members, communication regarding withdrawal of support, etc all ensure that fellows achieve high levels of skill. Didactic lectures on communication, leadership, and safety are provided during the program. Fellows’ communication skills are evaluated in a 360-degree format and considered in the evaluation process with each individual fellow. 3. Professionalism is highly valued and reinforced throughout the program. Didactic lectures on communication, leadership, and safety highlight what we believe to be the core of extended professionalism. Throughout the program, evaluation of the fellows’ behavior and skills by faculty and nurses, mentorship through fellows’ participation in administrative duties is performed and provided to the program director. 4. Systems based practice is mandatory throughout these specialties. Fellows are involved in PI/QA mechanisms and are actively involved in enhancement of systems based practice throughout their fellowship. The ICU and Trauma and EGS services are highly systems based and this permeates all aspects of care and training. 5. Practice based learning is achieved through numerous integrated mechanisms. Fellows participate in all aspects of the Division of Burn, Trauma and Critical Care’s efforts to maintain evidence-based practice of medicine and remain on the fore-front of the delivery of acute care management. Fellows are responsible for the reviewing and developing management protocols and guidelines, order set development, PI/QA initiatives, basic science and clinical research initiatives within the division. These activities are designed to enhance knowledge and improve patient care and outcomes.