Integrated Surgical Critical Care/Trauma Surgery?

[pcguy2]

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I was just wondering if there are any programs which integrate a year of surgical critical care into a GS residency. I was reading several GS residency programs which have a limited number of SCC spots avalible for fourth year residents. However, these spots are limited (3 spots in a 25 person residency). Any programs which garuntee these spots upon acceptance to the residency?

I've heard rumors of something called Acute Care Surgery. Is this a residency or fellowship? Or is it not even an reality yet?


Thanks much

 

[jubb]

I'm a student at Ohio State. Our program has recently become a 6 year program, the extra year can be used for research, but I think they also allow some of the residents to spend a year in the SICU. I think they only have 2 spots available for the 6 residents per year. I wouldn't take my word for it though, I'm just going off observation, I haven't actually asked anyone how that all works. But if you are interested you could ask them about it.

 

[Pir8DeacDoc]

I'm pretty sure that UT-Chattanooga offers a critical care year instead if research. Also, I'm pretty sure VCU in Richmond VA offers a burn fellowship instead of research.

I'm sure there are a huge number of these programs but that's the only ones that come to mind.

 

[pcguy2]

I see. Sounds like some programs just stick a fellowship year into it.

 

[Winged Scapula]

I was just wondering if there are any programs which integrate a year of surgical critical care into a GS residency. I was reading several GS residency programs which have a limited number of SCC spots avalible for fourth year residents. However, these spots are limited (3 spots in a 25 person residency). Any programs which garuntee these spots upon acceptance to the residency?

I am not aware of any programs which build a CC year in as a "guaranteed" path. As you note, there are several programs which offer it as an option, usually after the completion of 3 clinical years, but again, I am not aware of a formalized list which would contain such information about every program which has it (Penn State has it as well, but it is not guaranteed, as it requires an application). You might consider looking at http://www.apds.org Many programs list their CC positions there so it would give you an idea of what else is out there...depending on where you match, you may not have to do the CC year at your home program, as long as you can find a funded position elsewhere for that year.

I've heard rumors of something called Acute Care Surgery. Is this a residency or fellowship? Or is it not even an reality yet?

Thanks much

Not quite a reality yet. The idea is to create a fellowship which not only furthers the typical emergency or acute general surgery training yuo get in a surgery residency, but adds some training in basic ortho and neurosurg procedures. You might find these articles at EAST interesting: http://www.east.org/future.asp Also check out the college's Trauma section for more info (http://www.facs.org)

 

[pcguy2]

That makes a lot of sense. I've always had a hard time understanding the role of a trauma surgeon. They still need neurosurgeons and ortho to fix up big trauma cases (car crashes for example). Seems like this ACS actually trains the surgeon for a more complete way to care of those patients.

 

[Winged Scapula]

That makes a lot of sense. I've always had a hard time understanding the role of a trauma surgeon. They still need neurosurgeons and ortho to fix up big trauma cases (car crashes for example). Seems like this ACS actually trains the surgeon for a more complete way to care of those patients.

Perhaps...although I still suspect trauma surgery will continue to babysit patients for Ortho and Neurosurgery.🙄

 

[pcguy2]

Perhaps...although I still suspect trauma surgery will continue to babysit patients for Ortho and Neurosurgery.🙄

Really? Is Critical Care really not as cool as I think it is?

 

[Pilot Doc]

Really? Is Critical Care really not as cool as I think it is?

I think it's cool. But it's not really surgery. The link between surgery and critical care is a historical accident due to the post CABG/ open AAA patients for who ICU's were created. SOmebody had to take care of these sick patients and surgeon's were initially a logical choice.

But day in / day out care of critically ill patients is a very different skill set that most general surgery.

Getting back to your initial question, my impression, though I can't find any data to support it, is that you can do a critical care fellowship anytime after PGY3. So there's really no need for an "integrated" program. Any program that offers research time after PGY3 would give you the opportunity to do a CC fellowship - either at your program or somewhere else. I'm not sure what the advantage is of doing the fellowship during residency rather than after, but the option (I htink) is there.

 

[Winged Scapula]

Really? Is Critical Care really not as cool as I think it is?

Its not that its not cool, but as Pilot Doc notes, there's not much surgery or procedures involved. Most surgeons want to be in the operating room and given the current move toward non-op management of many trauma patients, its not all "ER" and "Critical Hour" in *most* places (ie, the obvious exceptions are the Knife and Gun clubs which still have a fair bit of operative time).

In reference to my comment above, its really not much fun when someone else (ie, Ortho or Neurosurg) gets to take to the patient to the operating room but you are the one stuck rounding on that patient, getting the calls about X,Y and Z and arranging post-hospital care.

 

[pcguy2]

Oh I see. Thanks so much for the info.

 

[Bitsy3221]

I was just wondering if there are any programs which integrate a year of surgical critical care into a GS residency. I was reading several GS residency programs which have a limited number of SCC spots avalible for fourth year residents. However, these spots are limited (3 spots in a 25 person residency). Any programs which garuntee these spots upon acceptance to the residency?

As a student at U of Minnesota, I am guessing you probably know about this already:
http://www.hcmc.org/education/residency/surgeryresidentinfo.htm

They have a required one year of research, and they are accredited for three of the four residents to do the SCC fellowship each year, so these odds are much better than the 3 in 25 that you were talking about.