Surgical Critical Care Fellowship  EDUCATION & CURRICULUM

CURRICULUM

Patient-Centered Bedside Learning

The foundation of any post-graduate training in surgery is patient-centered bedside learning, and the art of Trauma Surgery and Surgical Critical Care is no different. Clinical work should be rewarding, meaningful, and educational. There is a wide breadth of pathology at this center providing ample opportunity for in depth learning and skill growth.

Topic-Based Conference

The primary didactic conference for the academic year is the weekly Topic-Based Conference. This conference functions as a weekly presentation / lecture series on the topics central to a comprehensive education in trauma and critical care. The faculty will lead topic review for the majority of the annual calendar. The fellows will choose relevant topics of interest and prepare to lead this conference on six occasions spaced evenly throughout the year with the goal of having six high-quality academic presentations available for future use when the fellows transition to a faculty/attending position following completion of the program. A representative sample of topics are listed below. Fellows may choose from among these topics or create a topic of their own that they are interested in investigating further.

Trauma M&M

Trauma-specific Morbidity and Mortality (M&M) conference is held weekly to discuss complex cases and identify opportunities for improvement in delivery and quality of patient care. The fellow is expected to be an active participant in this conference that is critical to quality improvement of the division. Attendees include faculty, fellows, residents, students, advanced-practice providers, trauma support staff, and consultant service liaisons.

Trauma Grand Rounds

Trauma Surgery Grand Rounds is a once monthly exploration and discussion of a topic relative to the trauma patient population.

Critical Care Journal Club

A monthly Critical Care Journal Club is designed to review the landmark papers in critical care while also developing a deeper understanding of critical appraisal of the literature to develop the necessary skills to assess, interpret, and evaluate academic publications for ensure the practice of evidence-based medicine.

Quality Improvement / Research Meeting

Twice monthly meeting to assess progress in scholarly activity. The fellow is encouraged but not required to participate in original research. The ACGME does require scholarly activity during the fellowship year, however, and the fellow is expected to develop, carry out, and present a quality improvement project during the course of the 12-month program. There are opportunities to participate in ongoing department and division projects including multicenter trials, original research, and case reports and case series if interested.

Performance Improvement and Patient Safety (PIPS) Conference

Monthly conference to discuss system issues within the trauma center to improve the quality and delivery of care to the patients who enter and progress through our trauma center and system. Representatives from involved surgical subspecialties and hospital staff attend.

Professional Standards Committee (PSC) Conference

Monthly conference focused on multidisciplinary issues involving trauma patients. Relevant case discussions, policies, and protocols are some of the topics often discussed.

Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) Examination

The MCCKAP exam is a 4-hour, 200-question multiple-choice examination designed to assess critical care knowledge and patient management. The newly created surgical supplement contains an additional 100 multiple choice questions focused more specifically for surgical critical care fellows. This exam is the “best available” practice exam for the Surgical Critical Care Certifying Exam offered by the American Board of Surgery each year. The goal is to assess knowledge and identify areas of weakness to focus study in preparation for Surgical Critical Care board certification. This exam is provided to the fellow each year at no cost.

ROTATIONS

The rotation schedule for the Surgical Critical Care fellows for the 2023-2024 academic year is detailed below.

OLHS AMC = Ochsner LSU Health Shreveport Academic Medical Center
Electives = Anesthesia, Burn, ECMO / CRRT, Interventional Radiology, Medical ICU, Vascular Surgery

The above arrangement was thoughtfully chosen. The first month of the fellowship year should be spent learning as much as possible about caring for critically ill patients and dedicating focus to the patient care arena. Fellows will spend this time together in the primary ICU to allow time for division of patient care responsibilities and to facilitate studying for General Surgery board examination. The majority of the next ten months are spent separate to facilitate the greatest educational value and opportunity for growth. The bulk of that time is spent alternating between self-selected elective rotations; required rotations in the Surgical ICU, Neuro ICU, and on Critical Care Ultrasound, and in the primary Trauma ICU. Graduated autonomy will be fellow-dependent with the goal of an expanded role in each rotation in the core ICU after other rotations provide knowledge and skill set expansion. The remainder of the fellowship is designed to prepare the fellow for independent practice. Sequential elective rotations follow in the Spring under the assumption that the fellow is likely to have secured a permanent position for the coming year, and this time is designed to allow experiences in arenas that will be useful to the fellow in their specific practice arrangement following completion of the program. The final rotation in the core ICU is expected to see the fellows in independent command of patient care as they ready for solo practice in the coming months.

People, interests, and future career arrangements vary widely, and our goal is to provide a superb education in the care of complex critically ill patients while maintaining flexibility to best serve our prospective fellows in meeting their career goals. If the available elective rotations do not include an experience felt to be of value, our goal is to expand our offerings to meet the needs and interests of our fellows.