The philosophy of the Vanderbilt University Medical Center Surgical Critical Care and Acute Care Surgery Fellowship program is to provide a setting in which advanced, highly skilled, adult education can take place. The faculty provides the opportunity for the fellow not only to acquire an in-depth knowledge of critical care, trauma and emergency surgery, and advanced skills in critical care and operative techniques, but also to develop both academically and professionally. This is achieved through an integrated two-year program that includes an ACGME approved Surgical Critical Care Residency, AAST approved specialty training in the management of EGS and trauma patients, and the training to enhance administrative, research, and educational skills. We are committed to providing excellent clinical exposure, as well as directed, expert instruction, promoting self-directed education, and fostering the refinement of the fellow' scientific and academic pursuits. The educational program consists of a combination of mentorship with a graded increase in clinical, administrative, and educational responsibilities, didactic and Socratic instruction, hands-on experience, and self-directed learning.
To ensure that our program attains those goals and objectives outlined in our program philosophy, the VUMC Surgical Critical Care and Acute Care Surgery Fellowship defines several components in the program including:
- Research/Academic Development
For acquisition of clinical expertise, the fellowship is structurally divided into two separate years:
1) ACMGE approved Surgical Critical Care experience - 1st year
2) AAST - approved Acute Care Surgery experience - 2nd year.
For acquisition and enhancement of administrative, research, and educational skills, the two-year fellowship is an integrated program with the second-year building on the first year. Additionally, the second year provides opportunities to obtain specific expertise and skills in areas of interest defined by the fellow.
Fellows’ education during both years of the fellowship is supported by numerous weekly conferences designed to enhance the knowledge and skills in acute resuscitation, critical care, and acute care surgery.
1) ACGME approved surgical critical care experience - 1st year
Fellows help direct the management of a broad array of critically ill patients through monthly rotations in Surgical, Trauma, Cardiovascular, and Burn ICUs plus the Veterans Administration SICU. Fellows are an integral part of multidisciplinary critical care teams in each unit with oversight by dedicated critical care boarded faculty. 24/7 in-house Surgical Critical Care and Acute Care Surgery faculty and Surgical Critical Care fellows provide continuous direction and oversight of all critically injured and ill surgical patients.
2) AAST-approved Acute Care Surgery experience - 2nd year
After successful completion of the first year and review by the faculty, the second-year fellows receive an appointment as Instructors of Surgery and direct the care of critically ill and injured patients on the EGS, Trauma, and Burn services. In depth, structured oversight of fellow’s decision making and operative skills is provided through multiple mechanisms that allow a graded increase in independence: a) fellows’ rotations are paired with full time faculty to enable oversight and daily discussion of patients care, b) daily morning conference with review, check out, and discussion of critically ill patients with Surgical Critical Care and Acute Care Surgery faculty, c) structured review of fellows’ operative cases, complications, and patient care management as outlined in appendices I and II, d) monthly review of care and patient management by trauma, burn, and emergency general surgery service directorship and e) monthly, service-specific case review conferences. These processes are described in detail within the section “Policies for the Supervision of Surgical Critical Care and Acute Care Surgery Fellows”.
3) Burn Fellowship Option
For fellows interested in a career that incorporates a significant burn component, Vanderbilt offers the opportunity to complete either a formal Burn Fellowship or expanded experience in burn surgery. The goal of the Burn fellowship experience is to train surgeons and leaders in the care of patients with severe thermal and other etiologies of burn injuries. This includes an understanding of the operative management and critical care specific to the burn patient population, particularly focusing on operative techniques and decision making, outpatient care, long term sequelae and reconstructive management of the burn patient. The fellowship maintains a strong focus on professional development, research interests and leadership skills developed over the 2 years. Depending upon career goals, the fellow will emerge with a high level of proficiency to satisfy his/her career goals within the realm of the Burn Surgeon.