Post Residency Trauma training?

[JamesL]

I'm a new direct commission Guard physician, board certified fam med in a 62B slot. Our unit is a role 1/2. In my civilian job I am exclusively in outpatient clinic. While this is works well for doing PHAs and sick call, I am looking to do an OCONUS deployment in the future and would like to get some additional trauma experience prior to deployment.

I can't easily work/moonlight in an ER as an attending or take off a long stretch of time to do a fellowship. Are there any options where post residency doc like me to get more trauma experience? I'd be down to work at a resident scut monkey level (i.e. supervised) at a trauma center a few shifts a month if that was possible.

Thanks!

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[DeadCactus]

ATLS is a good first step if you haven't done that already.

The military has agreements with some major trauma centers to send physicians through for a train-up in trauma care. I've heard variable things about the quality of the experience. I don't think it's something you can arrange on your own though.

Hospitals seem get squirmy about having attendings working in a training role outside of formal programs. Do you know any surgeons or emergency physicians in your state's Guard? They may be your best chance of making something work.

 

[JamesL]

Appreciate it. Got ATLS and TCCC down. TCMC at some point. Nothing beats working in a trauma resus bay for experience IMO.

We do have a significant shortage of all docs in our State and haven't met any EM Guard docs yet. I'll reach out to the State Surgeon and ask.

 

[DeadCactus]

The challenge is that trauma care at the kind of facility that would give you enough volume for a few shifts to be worthwhile is pretty different from role 1 and role 2 trauma care. Additionally they tend to be crowded with residents and fellows who want the procedures that would be beneficial to you. If you can find a level 1 trauma center with no training program, it might work well.

If your efforts to get hands on time fail, I would probably:
1. Try to shadow for a shift or two just to see a refresher on how it plays out in real life,
2. Find a cadaver procedure lab.
3. Run drills/sims until you have the flow down to muscle memory.

Trauma is very algorithmic, even more so at a role 1 or 2. Just get the algorithm down. TCCC does a good job of giving you what you need to memorize to make use of your resources.

You could potentially find an animal simulation to participate in. I have mixed feelings on the value of this for anyone who regularly practices medicine on humans but this might be a situation where it makes sense.

 

[ATLS10]

Check out these ATLS 10 MCQs from the actual exam
ATLS10 exam questions with answers

 

[Gringoperdido]

Back when I was preparing to deploy, the local level I trauma team (Savannah Memorial Hospital) were kind enough to let me tag along - they had residents but let me run some trauma codes anyway. Wouldn't hurt to ask at your local level I. I also asked an anesthesiologists at the local MTF and he let me come in for a couple mornings and do the intubations. TCMC was an excellent course - highly recommended. Also, I did ATLS at a military base (Fort Gordon) and they had a pig lab, which was helpful for practicing chest tubes. This was all in 2006, so much may have changed.

 

[Lem0nz]

I don't think there are level one trauma programs without residents or fellows; pretty sure its a requirement. Just for a point of clarification. But as others have said, there are many level one trauma centers with standing armed forces agreements. I know Vegas had one for Nellis, Miami had one at Ryder that was I think more open to rotating groups that did a couple weeks to a month at a time IIRC. Most residents and fellows are happy to make space for service members; we know how important it is to you (and conversely how important you guys are to us). That was my experience.

 

[d2305]

Request to go to Bullis for C4, or what they call it now.

 

[JamesL]

Thanks everyone!

 

[pgg]

The JTS Clinical Practice Guidelines are a must-read for anyone deploying to a Role123.

Joint Trauma System

The Joint Trauma System is dedicated to the reduction of morbidity and mortality, and improved survivability for all trauma patients in wartime and peacetime.

jts.amedd.army.mil

For formal refresher training prior to deployment, you might go to the Navy Trauma Training Center in LA, which is at USC. Years ago there was a curriculum of lecture, lab, and clinical work - not sure how it's run now. The Penn thing they're standing up might be an east coast version of that, sort of.

 

[d2305]

I think I remember the ER residents going to Scripps or UC San Diego for trauma. I have no idea how you get TAD (TYD) there.