Fellowship Training Program in Surgical Critical Care

Philosophy

The Surgical Critical Care Fellowship Program at the University of Alabama, Birmingham provides an opportunity for the fellow to acquire an in-depth knowledge of the pathophysiology of critical care, treatment of the most severely injured/critically ill patients, and advanced skill in critical care techniques. The fellowship is a balanced program committed to excellent clinical exposure, as well as the refinement of the participant's research and administrative abilities. The educational program consists of a combination of mentoring by faculty, didactic and Socratic instruction, hands-on experience, and self-education.

Overview

University Hospital is the only American College of Surgeons (ACS) verified Level I trauma center in the state of Alabama. The Trauma Service receives patients from a primary catchment area of a seven county region served by Birmingham Regional Emergency Medical Services System (BREMSS), in addition to referrals from all of Alabama and surrounding states.

The fellow will be provided an in depth knowledge of therapeutic maneuvers and diagnostic modalities to manage the polytrauma patient, as well as the failing pre- and postoperative surgical patient. This will not only include the realm of general surgery, but will also include neurosurgical and cardiothoracic patients. The fellow is exposed to modalities such as CRRT, ECMO and TEE in our ICUs, in addition to more routine invasive hemodynamic monitoring and ventilator management strategies.

The fellow has full responsibility as trauma team leader, gaining a broad range of experience in the management of blunt and penetrating trauma. The fellows become proficient in the evaluation of critically-ill and injured patients; the initiation of appropriate and complete diagnostic evaluation; the development and implementation of patient care plans; providing leadership which facilitates the interaction within the entire team of caregivers and with the patients and their families.

Fellowship Program Structure

The critical care fellowship emphasizes clinical care. The trauma team evaluated just over 3700 traumas and just under 1000 burns for 2012. Inpatient admissions for trauma and burns were approximately 2300 and 500, respectively. The fellow has abundant clinical material to learn from with 56 total ICU beds (28 dedicated Trauma/Burn ICU beds, 8 Neurotrauma ICU beds, and 20 SICU beds) for our service line. In addition to a robust experience with Trauma, the SICU service provides critical care for the emergency general surgery, elective generalsurgery, ENT, OMFS, Ob/Gyn, Transplant, and Vascular patients (approximately 1500 patients/year). Approximately 20% of admitted trauma patient are penetrating trauma. Operative experience will be held within the maximum volume as stipulated by the ACGME.

Successful completion of the SCC curriculum qualifies the fellow to take the ABS Surgical Critical Care Examination.

Curriculum Months
Trauma/Burn ICU (TBICU) 6
Neurotrauma-Critical Care (NICU) 1
SICU 2
Cardiothoracic ICU 1
Electives 2

Other potential electives include: MICU, PICU, Trauma Anesthesia, and Critical Care Transport

Educational Aspects

  • Attend weekly journal club meetings led by the faculty.
  • Attend weekly didactic sessions.
  • Attend weekly Trauma Quality Improvement Conference and Department of Surgery Morbidity and Mortality Conference.
  • Opportunity to become instructors in ATLS.
  • Opportunity to become proficient at perioperative TEE in order to obtain Certification in Basic Perioperative Transesophageal Echocardiography through the National Board of Echocardiography
  • Opportunity to complete a formal one-day course on the proper use of Focused Assessment with Sonography for Trauma.
  • Opportunity for attendance at Advanced Trauma Operative Management (ATOM) Course.
  • Opportunity to participate in Continuous Renal Replacement Therapy (CRRT) Course.
  • Take the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) online exam, the Society of Critical Care Medicine endorsed in-training examination.
  • Participate in the education of the rotating residents and medical students as well as evaluate their performance.

Research

Research is encouraged but not required in this fellowship. Multiple opportunities exist for research within the division, if desired.

Center for Injury Science (CIS)

Crash Injury Research and Engineering Network (CIREN)

Alabama Resuscitation Center / Resuscitation Outcomes Consortium (ROC)

Program Application

The Surgical Critical Care Fellowship Program at UAB is accredited by the ACGME's Residency Review Committee for Surgery for two (2) twelve-month positions beginning in July of each year. Appointments are made through the National Residency Matching Program (NRMP) or through application to the Program Director.

Qualifications for the Surgical Critical Care Fellowship Program include:

  1. Graduation from an ACGME-approved general surgery residency program
  2. Board certification or eligibility
  3. Demonstrated ability to instruct residents and medical students

An interview and site visit will be arranged for applicants being considered for appointment. Applications are accepted starting April 1st to September 1st. Applications and inquiries regarding the program should be submitted to:

Patrick L. Bosarge, MD, FACS
Assistant Professor of Surgery
Program Director, Surgical Critical Care Fellowship Program
112 Lyons-Harrison Research Building
701 19th Street South
Birmingham, AL 35294
Phone: (205) 934-4911
Fax: (205) 975-7294
This email address is being protected from spambots. You need JavaScript enabled to view it.

To learn more about Graduate Medical Education at the University of Alabama, Birmingham visit http://www.uab.edu/medicine/home/residents-fellows.