The UNLV School of Medicine has a two-year Fellowship in Acute Care Surgery in Las Vegas. This Fellowship includes a one-year ACGME approved Surgical Critical Care Fellowship and the nation’s first AAST approved Acute Care Surgery Fellowship. The Acute Care Surgery curriculum includes trauma surgery, acute general surgery, pediatric surgery, thoracic surgery, vascular surgery, hepatobiliary surgery, neurologic surgery, orthopedic surgery, and interventional radiology. Electives are offered in burn surgery, colon and rectal surgery, rural surgery, and trauma systems. Training is completed at the University Medical Center, Nevada’s only Level 1 and Pediatric Level 2 Trauma Center, only Burn Center, and the state’s busiest Emergency Department. The Trauma Center cares for 4,500 patients per year and performs over 300 exploratory laparotomies and 50 thoracotomies. In addition, there are 2500 acute surgical cases per year. Requirements include completion of an approved residency in General Surgery and that the candidates be BC/BE. Candidates must also qualify for Nevada licensure and malpractice coverage. In addition to clinical excellence, a documented commitment to academic excellence is essential. Duties include active clinical participation on the surgical and critical care services, student and resident teaching, and research, all within the global mission of developing and expanding the program in its clinical and academic spheres. During the second year, the AAST approved Acute Care Surgery Fellowship begins. During this second year, after an initial period of in-depth supervised experience, the fellow will undergo a graded increase in responsibility to the level of junior faculty in Acute Care Surgery including; trauma surgery, emergency general surgery and surgical critical care. The fellow will have a faculty appointment and as an Instructor of Surgery, be credentialed as a member of the medical staff with full admitting and operating room privileges. During the AAST approved second year, fellows enrolled in the Added Qualifications in Burn Surgery Program will integrate 2-3 months dedicated to treating acutely burned patients in the Burn Center. The fellow will meet all requirements by the AAST for the ACS fellowship, using the elective months to focus on burns. This integrated experience in trauma, emergency general surgery, surgical critical care and burns over two years enables an in-depth understanding of the pathophysiology and management of acutely injured or critically ill surgical patients, principles of resuscitation, timing of operative intervention, critical care management, and the systems and resources required for high level care and assures that graduates can perform at high levels, independent of supervision.