I hope someone can shed some light for me. Is it difficult to secure a trauma fellowship coming from a community general surgery residency as compared to coming from a university program? Thanks.
Trauma fellowship question
- Thread starter Aspen4
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No.
Honestly, it's hard to not secure a trauma fellowship if you're training here in America.
Here's some stats for you.
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Ha, I can see it now . . .
Dr. SLUser walking down the hall of his fine hospital . . .
Ken Mattox jumps out, "Congratulations on your Trauma Fellowship!"
Dr. SLUser: "Huh? What Trauma Fellowship? I applied to Surg Onc, not Trauma."
Ken Mattox: "It doesn't matter, you've been drafted! Welcome to Trauma!"
Dr. SLUser: "F*ck"
Jumped into my head . . .
Dr. SLUser walking down the hall of his fine hospital . . .
Ken Mattox jumps out, "Congratulations on your Trauma Fellowship!"
Dr. SLUser: "Huh? What Trauma Fellowship? I applied to Surg Onc, not Trauma."
Ken Mattox: "It doesn't matter, you've been drafted! Welcome to Trauma!"
Dr. SLUser: "F*ck"
Jumped into my head . . .
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In response to the OP, Trauma is not a competitive fellowship, even at the biggest name places. A close friend of mine <ahem> matched from a small community program in Pennsylvania to Baltimore Shock Trauma. While he was shocked, it is not that unusual.
Ahh, the Trauma draft.......probably not too far away. If it did happen, I may find myself google mapping the trip from Wichita to Canada......
There was an interesting article in the blue journal within the last few months that talked about the trauma surgeon deficit, and the surprisingly good salary.....I'm honestly surprised more of us wouldn't specialize in Trachs and PEGs if we knew how lucrative it could be....
Found it.
I have known several staff leave for private trauma practice to the tune of 400k+ for a very light schedule. Couple in TX, one in AZ. You can get compensated very well these days if you are coming from large trauma center into private practice
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That would be about what my friend makes in PP Trauma Surgery (I'm not sure the schedule is "very light" what with q6 first call, q6 second call, but there is an academic week built into the month with no day time duties).
Guess I might be hijacking the thread here, but here's a question from an MS2 who (probably naively) thinks trauma surgery would be sweeeeeet.
What's the difference between these fellowships - Trauma, Surg Critical Care, and Acute Care? I see them listed individually & in combinations at different places. And the NRMP link (thanks for that) above was for Critical Care, but couldn't find Trauma on there anywhere.
Guess I'm a little confused as to what the specifics are, because at our institution, two of the trauma attendings did "trauma" fellowships, one did "critical care," and one didn't do a formal fellowship (at least not on the CV) but was in the military, but they're all referred to as the "trauma attendings."
My understanding of Acute Care is that its more of an emerging way to structure a surgery service than necessarily a unique training modality - rotate GS, trauma, SICU, ER, or something like that. Somebody clear me up if I'm off base.
What's the difference between these fellowships - Trauma, Surg Critical Care, and Acute Care? I see them listed individually & in combinations at different places. And the NRMP link (thanks for that) above was for Critical Care, but couldn't find Trauma on there anywhere.
Guess I'm a little confused as to what the specifics are, because at our institution, two of the trauma attendings did "trauma" fellowships, one did "critical care," and one didn't do a formal fellowship (at least not on the CV) but was in the military, but they're all referred to as the "trauma attendings."
My understanding of Acute Care is that its more of an emerging way to structure a surgery service than necessarily a unique training modality - rotate GS, trauma, SICU, ER, or something like that. Somebody clear me up if I'm off base.
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QFT.
I'm glad there's people around who want to do Trauma.The Acute Care Surgery model is relatively new as you note. It generally includes a combination of emergency general surgery, trauma, neuro and ortho training. It may or may not include enough critical care training to be BE in CC.
Critical Care fellowships are open to a number of specialties and can be MICU, PICU or SICU based and usually are not focused on trauma alone, but the entire range of critical illnesses and any relevant procedures in that arena. Completion allows one to sit for the CC boards.
Finally, Trauma fellowships can be combined with CC or completed alone; you may not get the Ortho and Neurosurg training seen in the Acute Care Models.
Trauma fellowships are not run by the NRMP. Herehttp://www.trauma.org/index.php/resources/fellowships/C70/ is the link for trauma, critical care and acute care fellowships. There may be others around too (check east.org for more info as well).
I'm not sure if its because there isn't a board for Trauma Surgery, but its not uncommon for people to refer themselves as Trauma Surgeons without having done a fellowship. Hell, it sounds cooler than saying I'm a surgeon who does some trauma (we see the same thing in Breast Surgery - not that its cool but that general surgeons will refer to themselves as breast surgeons even when they do lots of GS because they know the term breast surgeon can be a marketing tool). But all in all, if your practice is entirely trauma it doesn't make a difference if you did the fellowship because you are a trauma surgeon, right?
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Thanks for the info, WS.
In your opinion or experience, do you see many people who are solely GS-trained (meaning no fellowship) taking some of those 1500 job openings, or do you have to be fellowship-trained if you want to do primarily trauma?
Put another way, would a trauma-heavy residency program qualify you to go into without having to move somewhere else for a year-long fellowship? I hate moving. 🙄
In your opinion or experience, do you see many people who are solely GS-trained (meaning no fellowship) taking some of those 1500 job openings, or do you have to be fellowship-trained if you want to do primarily trauma?
Put another way, would a trauma-heavy residency program qualify you to go into without having to move somewhere else for a year-long fellowship? I hate moving. 🙄
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Aren't some pretty wary of the acute care model for that reason--i.e. it's great that you get a little neuro and ortho training, but it won't ever come into use because ortho or neuro will just be paged when associated trauma comes in?
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The theory is that geographically there are large areas of this country that don't have neurosurg coverage or enough ortho coverage and that since gen surg is critical for any hospital's success, having a true acute care surgeon might help in the stabilization of complex trauma before they're shipped off to a level I trauma center. I think acute care works better as a model in the West, Rockies, SW and South where the population tends to be less dense.
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re above:
To be recognized as a "trauma surgeon" one completes a surgical critical care fellowship, and this is the recognized pathway. When you apply for jobs people look to see that you have your critical care boards. You thus add value to the facility/practice because of the whole leapfrog initiative thing---they have ICU patients managed by board certified intensivists. It is becoming increasingly common for ICUs to want their docs to be critical care boarded-this is the new standard of care.
Regarding the whole acute care surgery thing-everyone has backed away from the thought of you covering operative neuro or ortho, the trend now is to cover an acute care surgery service where you cover ER general surgery consults. This frees the hospital to hire specialists and thus they get the referrals for elective stuff so that patients can see a specialist breast surgeon or surgical oncologist or bariatric surgeon. In my practice I cover trauma, ICU consults (e.g., post op sick surgical patients), and on certain days gen surg in patient and ER consults. I work essentially shifts with a hospital employed group. I have weeks on and weeks off. During weeks on I cover my patients during the day and at night q3 when I am on call.
I find the field nice because it is a good mix---the intellectual interest of ICU patients, e.g sepsis, ARDS, pegs/trachs; the excitement of trauma, recent stab wound to chest comes to mind, and the operations of gen surg coverage, lap choles/appys and abdominal disasters.
Yes, people make 400+. The hours vary drastically by practice type-either I am on or off by week, and work to off ratio is approximately is 60:40, which seems about standard.
It is stressfull-you care for the sickest of the sick by definition, but good if that's your thing.
To be recognized as a "trauma surgeon" one completes a surgical critical care fellowship, and this is the recognized pathway. When you apply for jobs people look to see that you have your critical care boards. You thus add value to the facility/practice because of the whole leapfrog initiative thing---they have ICU patients managed by board certified intensivists. It is becoming increasingly common for ICUs to want their docs to be critical care boarded-this is the new standard of care.
Regarding the whole acute care surgery thing-everyone has backed away from the thought of you covering operative neuro or ortho, the trend now is to cover an acute care surgery service where you cover ER general surgery consults. This frees the hospital to hire specialists and thus they get the referrals for elective stuff so that patients can see a specialist breast surgeon or surgical oncologist or bariatric surgeon. In my practice I cover trauma, ICU consults (e.g., post op sick surgical patients), and on certain days gen surg in patient and ER consults. I work essentially shifts with a hospital employed group. I have weeks on and weeks off. During weeks on I cover my patients during the day and at night q3 when I am on call.
I find the field nice because it is a good mix---the intellectual interest of ICU patients, e.g sepsis, ARDS, pegs/trachs; the excitement of trauma, recent stab wound to chest comes to mind, and the operations of gen surg coverage, lap choles/appys and abdominal disasters.
Yes, people make 400+. The hours vary drastically by practice type-either I am on or off by week, and work to off ratio is approximately is 60:40, which seems about standard.
It is stressfull-you care for the sickest of the sick by definition, but good if that's your thing.
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Yes I did critical care for a year. Some one year programs are "trauma/critical care" but no one year program can involve too much trauma as the boards mandate that it is 9 months non operative critical care.
The two year programs are still in evolution as to what to do with the second year. Some offer a neurosurg or ortho elective but everyone involved has backed away from saying that you would actually do those cases. From the AAST website, describing acute care surgery, "This specialty requires broad training in elective and emergency general surgery, trauma surgery, and surgical critical care." The website says that there could be a mix of elective time in vascular, thoracic and transplant/hepatobiliary.
Regarding schedules, most seem based on a shift-work type, either 24-hour shifts or week shifts as I do. You will find though that when you look at actual jobs they vary a lot based on how much you want to work and how much you want to make, along with the whole private practice academics thing.
As to who is a trauma surgeon: it is typically someone who has done surgery and critical care. Most critical care fellowships are at trauma centers and involve also training in trauma. However, the complicated thing about trauma is typically the critical care.
The two year programs are still in evolution as to what to do with the second year. Some offer a neurosurg or ortho elective but everyone involved has backed away from saying that you would actually do those cases. From the AAST website, describing acute care surgery, "This specialty requires broad training in elective and emergency general surgery, trauma surgery, and surgical critical care." The website says that there could be a mix of elective time in vascular, thoracic and transplant/hepatobiliary.
Regarding schedules, most seem based on a shift-work type, either 24-hour shifts or week shifts as I do. You will find though that when you look at actual jobs they vary a lot based on how much you want to work and how much you want to make, along with the whole private practice academics thing.
As to who is a trauma surgeon: it is typically someone who has done surgery and critical care. Most critical care fellowships are at trauma centers and involve also training in trauma. However, the complicated thing about trauma is typically the critical care.
