Current/Past SICU fellows- experience

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fly1346

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Wondering what the experience of current or past fellows in SICU/Trauma fellowships have been.

Currently in 1 myself, and for someone who loved surgery and enjoyed every minute of surgical residency, I am miserable. No autonomy, not many procedures or operations. Moreover the culture at this program is a tight knit where the attending relies on the NP/PA service + 2-3 rotating+ surgical residents. I am Pretty much a wall flower. Don’t lead icu rounds, don’t really have much input on patient care, I’m just an “observer”. Will occasionally help the residents and walk them thru procedures ( a-lines, central, bronchs)

Was wondering if this is normal throughout nationwide programs? Don’t know if this is because we are only there for 1 year, so aren’t really taken seriously. Was wondering what other fellows experiences have been

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I'm maybe not your best source, but when I was an ortho resident at a large level 1 trauma center our 3x SICU fellows were there for two years. They ran SICU rounds with patients being presented by the intern/PA/NP, the fellows were on overnight and basically functioned as the "jr attending" running around putting out fires - either running codes or procedures in the SICU (bronchs/intubations/central lines), & operating on trauma call cases.

I would say our SICU fellows had lots of autonomy in the SICU and just ran difficult cases by the trauma attendings. The trauma attendings were there and scrubbed for the majority of on call trauma cases unless it was routine.

So I would wonder if there is a way to increase your role in your fellowship. Most attending's usually will treat you more as a colleague when you are a fellow than when you were a resident. So I would bring up your concerns with your attendings and ask for more cases/more responsibility and I would think they would be happy to give it to you unless for some reason you are really struggling.
 
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I'm maybe not your best source, but when I was an ortho resident at a large level 1 trauma center our 3x SICU fellows were there for two years. They ran SICU rounds with patients being presented by the intern/PA/NP, the fellows were on overnight and basically functioned as the "jr attending" running around putting out fires - either running codes or procedures in the SICU (bronchs/intubations/central lines), & operating on trauma call cases.

I would say our SICU fellows had lots of autonomy in the SICU and just ran difficult cases by the trauma attendings. The trauma attendings were there and scrubbed for the majority of on call trauma cases unless it was routine.

So I would wonder if there is a way to increase your role in your fellowship. Most attending's usually will treat you more as a colleague when you are a fellow than when you were a resident. So I would bring up your concerns with your attendings and ask for more cases/more responsibility and I would think they would be happy to give it to you unless for some reason you are really struggling.
This reflects my experience in residency as well. Big trauma center, 80ish SICU beds, had 2 SICU fellows per year (1-yr fellowship), an army of APPs, and junior residents.
 
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Speak up and take charge. If the resident\APP is presenting and you say nothing, your attending has to step in and lead. If you add information, guide their decision making, make sure things aren't missed, and teach, your attending can step back. They have no idea how much you know or are capable of until you show them, and they have a responsibility to make sure the patients are cared for - if you aren't doing it they will have to take over.

As for operating that totally depends on the program - if you have seen one SCC fellowship then you have seen one SCC fellowship, they are all different. Some include time on the trauma service, burns, covering EGS on call, etc. so you get cases; some you literally only do critical care and don't leave the ICU for the entire year. Some make you stay a second year if you want any operative time, some include it in the first year. This is something you have to figure out during the interview process from asking current fellows and looking at the rotation schedule, so that you end up in a place that fits your needs\wants as well as possible.
 
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Wondering what the experience of current or past fellows in SICU/Trauma fellowships have been.

Currently in 1 myself, and for someone who loved surgery and enjoyed every minute of surgical residency, I am miserable. No autonomy, not many procedures or operations. Moreover the culture at this program is a tight knit where the attending relies on the NP/PA service + 2-3 rotating+ surgical residents. I am Pretty much a wall flower. Don’t lead icu rounds, don’t really have much input on patient care, I’m just an “observer”. Will occasionally help the residents and walk them thru procedures ( a-lines, central, bronchs)

Was wondering if this is normal throughout nationwide programs? Don’t know if this is because we are only there for 1 year, so aren’t really taken seriously. Was wondering what other fellows experiences have been

Is it a one fellow a year program, so no one else to compare/contrast/commiserate? Could you reach out to prior grads and see what their opinions of the program are now that they’ve graduated? Does this jive with what you heard from prior fellow(s) in interviews or is it way out of left field?

As a current fellow (non-trauma), that sounds miserable and not worthwhile and if I found my one year fellowship were not preparing me to do what I wanted and I was working ridiculous hours to be a “wallflower” for fellow pay, I would absolutely walk away quickly without looking back. There are many solid general surgery jobs out there available without fellowship.
 
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