Surgical Critical Care Fellowship

Program Description
The program is a one-year accredited surgical critical care fellowship integrated with a general surgery residency at a tertiary regional referral center located at the Erlanger Medical Center in Chattanooga, Tennessee.  The Surgery Residency Review Committee (RRC) approved the program for up to two fellows each year.  The hospital facility houses its own flight program with two Aeromedical helicopters which transport a variety of emergency general surgery, vascular, and trauma patients from a 120-mile radius.  The fellowship is attended by five full-time faculty general surgeons who are board certified in surgical critical care. 

Ten months of the academic, year each fellow rotates on the Surgical Critical Care Service which provides care for a variety of trauma, general surgery, vascular, and obstetrical critical care patients with an average daily census of 20-24 patients.  One-month electives are also offered in management of burn patients and pediatric critical care.  The fellowship also offers unique experiences with continuous renal replacement therapy and airway pressure release ventilation.  Applicants must be a clinical PGY-4 level or higher at the time they would begin the fellowship program, in either a Categorical General Surgery Residency position or be board eligible in General Surgery.

The first Surgical Critical Care Fellow in our program was Ben Dart, MD, from our own Surgery Residency Program (January 1 - December 31, 2003).  After he completed both the Fellowship and the Surgery Residency, Dr. Dart joined the faculty and now serves as Medical Director of the Surgical Skills and Simulation Lab.

Research Opportunities
Development of a clinical research project with expected presentation at a national meeting and publication in a peer-reviewed journal is a major priority in this program.  A laboratory facility capable of various cytokine assays is available to facilitate research efforts.  Each fellow will be expected to

participate in protocol development and implementation and will attend a number of committee meetings allowing experience in the administrative responsibilities of an ICU director.

Medical Student Elective
The close attending supervision and the role of fellows and residents assigned to the Surgical Critical Care Service allows the program to offer an excellent fourth year elective for medical students.  Exposure to ventilator management, invasive hemodynamic monitoring, management of intracranial hypertension, septic patients, use of continuous renal replacement therapy (CRRT), resuscitation of trauma patients, electrical injuries, and a number of other diverse life threatening scenarios allow for a tremendous learning experience for the ambitious medical student desiring to continue on in a surgery residency or perhaps those desiring a career in emergency medicine.  Participation in this rotation as an acting intern would result in numerous procedures as well as a letter of recommendation if requested for residency application.  Call arrangements would be made with the Critical Care fellows and Surgery residents.