Can ER Docs do a trauma fellowship?

[Jamaican MD]

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Or is that just for the folks that have done a gen surg residency? Thanks 👍

 

[pushinepi2]

Or is that just for the folks that have done a gen surg residency? Thanks 👍

There are a couple of other threads that have indirectly addressed this question. Many of the surgical critical care (post gen surg/trauma) fellowships will accept ER physicians. The second year is optional for EP's; often it is reserved for research or MPH pursuits. Check out the Society for Academic EM's page for some more info. Offhand, I know the trauma surgical critical care fellowships at UMaryland and Ryder Trauma Center at Jackson Memorial accept emergency providers. Again, there's more in depth discussion of this topic at the professional websites like ACEP, SAEM, and EMRA. Check em out.

Good luck,

p-u-s-h

 

[Jamaican MD]

There are a couple of other threads that have indirectly addressed this question. Many of the surgical critical care (post gen surg/trauma) fellowships will accept ER physicians. The second year is optional for EP's; often it is reserved for research or MPH pursuits. Check out the Society for Academic EM's page for some more info. Offhand, I know the trauma surgical critical care fellowships at UMaryland and Ryder Trauma Center at Jackson Memorial accept emergency providers. Again, there's more in depth discussion of this topic at the professional websites like ACEP, SAEM, and EMRA. Check em out.

Good luck,

p-u-s-h

Thank you. 🙂

 

[NeedMyCoffee]

The University of Maryland runs a Trauma Fellowship specifically for Emergency Physicians for 1-2 years. The little blurb from the SAEM website reads as follows:

Surgical Critical Care / Trauma Fellowship
University of Maryland Medical System and
R Adams Cowley Shock Trauma Center
Program Director, Surgical Critical Care Fellowship: Steven B. Johnson, MD, FACS
Director Program in Trauma: Thomas M. Scalea, MD, FACS
Residency Coordinator: Debra A. Henry
22 South Greene Street
Phone 410-328-5830, Fax: 410 328-0687
Email [email protected]
Length 1-2 years
Salary Standard PGY-4 or PGY-5
No. of Positions 4
Deadline Open

Check it out! I hear it's a very well run fellowship.

Hope this helps.

 

[southerndoc]

One thing to note is that these trauma fellowships doesn't qualify you to perform surgery on trauma patients. I'm not sure if the original poster is hinting at this or not.

 

[NinerNiner999]

Yeah - if you want to do trauma surgery, you will need a surgery residency. I have worked with a couple of the MD critical care fellows and they are basically in charge of the trauma patients pre and post-op, basically a trauma SICU.

 

[droliver]

Most trauma fellowships would not consider an EM candidate as the trauma fellows frequently serve multiple roles including staffing some general surgery cases as well as taking attending in-house call for the trauma service. With the two year fellowships, the fellows also bill as an attending surgeon during the 2nd year (the first year would be your ACGME year to be able sit for the critical care board)

 

[KGUNNER1]

Most trauma fellowships would not consider an EM candidate as the trauma fellows frequently serve multiple roles including staffing some general surgery cases as well as taking attending in-house call for the trauma service. With the two year fellowships, the fellows also bill as an attending surgeon during the 2nd year (the first year would be your ACGME year to be able sit for the critical care board)

Please check out the survey we did a few years ago on the ACEP website. It is a few years old, so you should call the programs directly if you are interested. About 30% of the responding Surgery CCM programs would accept an EM grad.

http://www.acep.org/1,32643,0.html

KG

 

[droliver]

Kyle,

interesting reference, although knowing something about a few of the programs that indicated yes, I can't believe it could work without massive restucturing of their current program. The receptiveness to this in large part will depend on the role of the fellow, who again, at many programs functions in large part as junior surgery faculty. I suspect that in 2005 the response at many programs could be even more accomadating for EM backgrounds who are interested because most trauma fellowships are no longer filling at all

rob

 

[KGUNNER1]

Kyle,

interesting reference, although knowing something about a few of the programs that indicated yes, I can't believe it could work without massive restucturing of their current program. The receptiveness to this in large part will depend on the role of the fellow, who again, at many programs functions in large part as junior surgery faculty. I suspect that in 2005 the response at many programs could be even more accomadating for EM backgrounds who are interested because most trauma fellowships are no longer filling at all

rob

The bad news about CCM fellowships and ED grads are that they aren't recognized by ACGME, and thus not funded through traditional avenues. The good news is that they aren't recognized by ACGME and thus aren't regulated by ACGME or the RRC, therefore their spots don't count against the program. So these trauma heavy programs could still fill with surgeons and the ED grad could moonlight as an ED attending to help supplement their salary. This is just one example. I've seen many creative ways to fund EM/CCM fellowships at programs new to the EM grad filling CCM spots.

kg

 

[waterski232002]

The bad news about CCM fellowships and ED grads are that they aren't recognized by ACGME, and thus not funded through traditional avenues. The good news is that they aren't recognized by ACGME and thus aren't regulated by ACGME or the RRC, therefore their spots don't count against the program. So these trauma heavy programs could still fill with surgeons and the ED grad could moonlight as an ED attending to help supplement their salary. This is just one example. I've seen many creative ways to fund EM/CCM fellowships at programs new to the EM grad filling CCM spots.

kg

So... are you saying that EM grads must work for free during their fellowship. And in order to keep some income you would need to moonlight?

 

[FoughtFyr]

So... are you saying that EM grads must work for free during their fellowship. And in order to keep some income you would need to moonlight?

No, what he is saying is that being outside of the ACGME control, moonlighting is less restricted b/c work hours rules do not apply.

- H

 

[pushinepi2]

So... are you saying that EM grads must work for free during their fellowship. And in order to keep some income you would need to moonlight?

Im sure Kgunner1 can speak with more authority on this issue, but most EM grads pursuing a trauma/cc fellowship are salaried at the standard pgy4 or 5 level. Income from working additional shifts as an ED attending can supplement the fellow's salary. There are some other fellowships, however, that view junior attending shifts are REQUIRED of fellows in training. It is important to ask these specific questions when contemplating application. The UMass EMS fellowship, as I recall, paid the fellow as a PGY 4 or 5. The fellowship also required some shifts in the UMass ED.

PuSh

 

[KGUNNER1]

Im sure Kgunner1 can speak with more authority on this issue, but most EM grads pursuing a trauma/cc fellowship are salaried at the standard pgy4 or 5 level. Income from working additional shifts as an ED attending can supplement the fellow's salary. There are some other fellowships, however, that view junior attending shifts are REQUIRED of fellows in training. It is important to ask these specific questions when contemplating application. The UMass EMS fellowship, as I recall, paid the fellow as a PGY 4 or 5. The fellowship also required some shifts in the UMass ED.

PuSh

Exactly. I'm not saying that every program requires moonlighting. Established programs like Pitt and Shock Traum in Maryland fund the EM/CCM fellow 100%. However, some newer programs may shy away from trying to find the funding. The EM grad can help supplement their income by working a few shifts as a junior faculty, much like the Trauma Fellow working as junior faculty in the OR.

My point is that funding and regulation are wide open which allows for a ton of creativity. Estabilished programs function like any traditional fellowship and you don't have to worry about it. You really should discuss the details with the program you're interested in early in your decision to to a CCM fellowship.

They way the "rules" are set up now, if you want to be a trail-blazer, you can.

kg

 

[waterski232002]

Exactly. I'm not saying that every program requires moonlighting. Established programs like Pitt and Shock Traum in Maryland fund the EM/CCM fellow 100%. However, some newer programs may shy away from trying to find the funding. The EM grad can help supplement their income by working a few shifts as a junior faculty, much like the Trauma Fellow working as junior faculty in the OR.

My point is that funding and regulation are wide open which allows for a ton of creativity. Estabilished programs function like any traditional fellowship and you don't have to worry about it. You really should discuss the details with the program you're interested in early in your decision to to a CCM fellowship.

They way the "rules" are set up now, if you want to be a trail-blazer, you can.

kg

I'm still a little confused about what you mean by newer programs "shying away from trying to find the funding"... If they do not obtain funding for you as a fellow, than doesn't that mean that your PGY4/5 salary would NOT be financed, thus you would only receive income from the "junior attending" shifts you work (whether required by the program or not) and/or moonlighting?

Thanks for explaining....

 

[ERMudPhud]

There are other sources for funding. The hospital could decide to pay for the fellow out of pocket because having a fellow even if you have to fund them entirely yourself without outside funds is still better than not having one. Or the intensivist group could kick in to pay for the fellow because they see the value in having a fellow. EM programs that take people who have already done another residency are making a similar decision

 

[Apollyon]

There is a difference between one program and another with the pay grade - as stated above, some are PGY4-5 (~$50K/yr), and others are "half-attending" pay (~$65-70K/yr), but, also, at half-attending, you work attending shifts in the ED.

However, this is all malleable - as KG says, if you want to blaze trails, you can. And, no matter what anyone says, no one works for free. As a fellow and junior faculty, you're treated more as an equal, and, if you have an idea that saves/makes money, you WILL be listened to.

I know it sounds a little nebulous, but it works, because we know it works. I am aware that my post is redundant, but, if there's a place you want to be, if you come to the table with your application AND a proposal for funding, you'll be looked at in a much brighter light.

 

[KGUNNER1]

I'm still a little confused about what you mean by newer programs "shying away from trying to find the funding"... If they do not obtain funding for you as a fellow, than doesn't that mean that your PGY4/5 salary would NOT be financed, thus you would only receive income from the "junior attending" shifts you work (whether required by the program or not) and/or moonlighting?

Thanks for explaining....

ERMudPhud and Apollyon are exactly correct. All GME funding that is approved by ACGME is largely funded through Medicare. The hospitals get x $ for each resident position. Once you fill, you get no more $. So if the program decides it really needs more residents, they can hire more residents. They just won't get GME $ for them. They'll have to find other ways to pay for it. I'm not going to go into why this doesn't happen more, because the RRC really frowns on programs with more residents than they are approved for and there is a ton of paperwork and justification that needs to be satisfied.

So if you join a fellowship that is full, because you aren't from a "recognized" specialty than can take US CCM boards, the GME/RRC/ACGME doesn't recognize that you even exist. All they know is that you are a graduate of an accredited EM program and are thus board eligible for EM boards.

So this fellowship doesn't get GME funds to pay you. How will you survive? Programs like Pitt and Shock Trauma already have internal funding for this. Other programs that are "new" to this idea may not. This is where you may become creative and function in other ways to cover your salary. You may be successful and talk the department into fully supporting your salary and benefits out of the goodness of their hearts. If they aren't willing to do that, this is where you can get crafty.

Most fellows get the PGY 4 and 5 salaries at their hospital. You may have moonlighting opportunities (hospitalist for IM grads etc...) to supplement this.

Hope this helps.
kg

 

[waterski232002]

Thanks for the clarification...