Surgical Critical Care Fellowship
About the Surgical Critical Care Fellowship
The mission of the fellowship is to provide the clinical, educational, and administrative environment and resources for fellows to develop advanced proficiency in the management of critically ill surgical patients, to develop the qualifications necessary to supervise surgical critical care units, and to conduct scholarly activities in surgical critical care. The fellowship provides a broad based clinical experience and training in adult or pediatric surgical critical care allowing qualification for board certification in surgical critical care.
The Adult track of the surgical critical care fellowship provides a rich educational, clinical and administrative environment allowing fellows the opportunity to develop advanced proficiency in the management of the critically ill adult surgical patient. It provides the necessary experience to supervise surgical critical care units. The program also seeks to provide fellows with the necessary skills to conduct multidisciplinary scholarly activities within the field and to further enhance and advance knowledge of the critically ill surgical patient. Harper University Hospital and its SICU service are the primary teaching facility and service for the Adult track of the fellowship. The SCC faculty is comprised of six general surgery and anesthesia attendings. Five to six months of training are spent at this site. The patient population consists of cardiothoracic (including ECMO), general, vascular and surgical oncology patients, among other subspecialties. The surgical critical care fellow supervises and provides care for patients admitted to the SICU team which consists of a dedicated attending intensivist, surgery and anesthesia residents, and other medical professionals. Additional training sites include the SICU services of Detroit Receiving Hospital and Sinai Grace Hospital, both of which predominantly care for trauma and acute care surgery patients. There is a full didactic program consisting of several weekly lectures, a weekly journal club, and a monthly M&M conference. A self-study curriculum is based on Decker’s Critical Care of the Surgical Patient on-line text.
Children’s Hospital of Michigan and its department of pediatric surgery serve as the primary clinical site and teaching faculty, respectively, for the Pediatric track of the surgical critical care fellowship. Prospective applicants have usually completed their general surgery training, while a minority pursue training after three years. Although not a requirement, the majority of fellows have a specific interest in pediatric surgery. The Pediatric track provides the fellow with the opportunity to enhance their management of the critically ill surgical child by providing one-on-one care for patients in the Neonatal and Pediatric Intensive Care Units under the supervision of six pediatric surgery faculty, most of which are also board certified in critical care. The spectrum of diseases encountered includes, but is not limited to, congenital diseases such as congenital diaphragmatic hernia, congenital pulmonary airway malformations, tracheoesophageal fistula/esophageal atresia, abdominal wall defects (gastroschisis and omphalocele), neonatal bowel obstructions, Hirschsprung’s disease, and neonates with necrotizing enterocolitis. In addition, patients requiring ECMO support are managed by the department. As a level I trauma center and pediatric burn center, fellows also enhance their surgical expertise caring for trauma and major burn patients. The gamut of pathophysiology allows the fellow to acquire procedural skills and techniques needed to provide optimal surgical care of critically ill children and allows graded and progressive responsibility, a goal of the training program. The fellow participates in a weekly joint didactic curriculum with the pediatric surgery fellows and faculty which focuses on the basic science and clinical aspects of pediatric surgical diseases through pathology, radiology, M & M, research, and joint specialty combined conferences. Participation in the pediatric critical care didactic lecture series is also encouraged. Fellows are provided the opportunity to participate in the adult track’s weekly didactic and self-study curriculum to further enhance their knowledge base.