SURGICAL CRITICAL CARE FELLOWSHIP
The Surgical Critical Care (SCC) Fellowship program was established in 2003 and has been continuously accredited by the Accreditation Council for Graduate Medical Education since then. The fellowship focuses on the management of critically ill surgical patients, providing fellows with the expertise necessary to provide comprehensive care in intensive care settings. They learn to handle a wide range of conditions, such as severe trauma, organ failure, complex surgical infections, and postoperative complications. The fellowship emphasizes critical care principles, ventilator management, hemodynamic monitoring, and advanced resuscitation techniques, and equips doctors with the skills to navigate the complexities of managing life-threatening conditions, optimizing patient outcomes in critical situations.
The program is committed to delivering excellent clinical exposure, as well as directed, expert instruction, promoting autonomous education, and fostering the refinement of fellows' scientific and academic pursuits. The fellowship consists of a combination of mentorship with a gradual increase in clinical, administrative, and educational responsibilities; didactic instruction; hands-on experience; and self-directed learning.
PROGRAM INFORMATION
Our surgical critical care fellowship is designed to give graduating fellows a firm foundation to elevate their surgical career. Our fellows our trained to be competent, caring physicians who are capable of caring for the most complex surgical cases. Learn more below!
- Develop Expert Critical Care Specialists: Train highly skilled and competent surgeons capable of providing comprehensive and specialized care to critically ill and injured patients.
- Advance Patient Outcomes: Focus on refining fellows' abilities to provide timely and effective critical care interventions that lead to improved patient outcomes, reduced complications, and improved quality of life.
- Promote Multidisciplinary Collaboration: Foster collaboration with various medical specialists, including intensivists, anesthesiologists, nurses, and allied healthcare professionals, to ensure holistic patient care.
- Encourage Research and Evidence-Based Methods: Engage fellows in critical care research and evidence-based methods, contributing to the evolution of protocols, treatment strategies, and innovations in surgical critical care.
- Cultivate Leadership Skills: Develop leadership skills that enable fellows to lead critical care teams, coordinate patient care, and manage complex clinical scenarios.
- Foster Professional Growth: Provide a supportive environment for fellows' professional growth, encouraging their pursuit of academic roles, teaching opportunities, and contributions to the field of surgical critical care.
- Empower Compassionate Care: Instill a patient-focused approach, emphasizing effective communication, empathy, and compassionate care to patients and their families during critical illness.
- Champion Ethical Practice: Engender ethical values and principles, ensuring fellows prioritize patient well-being, respect patient autonomy, and maintain the highest standards of integrity in their practice.
- Prepare for Certification and Practice: Equip fellows with the knowledge and expertise necessary to pursue board certification in surgical critical care, ensuring they meet the highest standards of competence and ethical practice in the field.
The year-long SCC fellowship can be completed independently or as part of a 2-year track in which the first year is focused on SCC and the second on acute care surgery. One position per track is available each academic year.
In addition to their clinical training, fellows will participate in our trauma committee, SICU IDC meetings, and more as part of their systems education. Fellows will also be exposed to weekly lectures on SCC topics and AAST ACS modules, as well as a robust critical care ultrasonography (CCUS) curriculum. The CCUS curriculum includes lectures and hands-on training in conjunction with our Emergency Ultrasound Fellowship, and the education received on echocardiography involves computer modules and hands-on training with anesthesiology and cardiology while at the Veterans Affairs Medical Center.
Didactics
The following is a list of timely topics that are covered during lectures every Tuesday from 2 to 3 p.m. in the SICU Conference Room and broadcasted over Zoom. These lectures are geared towards our SCC and ACS fellows and it is mandatory that they attend; however, the burn surgery fellow, residents, and medical students are welcome as well.
AAST ACS Module Topics
- Pleural infections; parapneumonic effusions/empyema
- Sacral pressure injury
- Palliative care in critical illness
- Severe and complicated c. diff
- Necrotizing soft tissue infections
- Difficult airway
- Ischemic bowel disease
- Cardiac tamponade
- Sternal fracture/rib fracture/SSRF
- Traumatic brain injury
- Fat embolism syndrome
- Abdominal compartment syndrome
- GI bleeding
- Nutrition/feeding access/short gut
- GE varices
- Blunt cardiac injury
- Vascular interventions for hypothermia
- Pelvic vascular injuries
- Acute ischemia of extremities
- Air embolism
- Iatrogenic vascular injuries
- Vascular intervention for VTE prophylaxis and treatment
- Tracheobronchial injuries
- Esophageal perforation
- Femoral artery injuries
- Vena cava injuries
- Ascending aorta injuries
- Blunt aortic injuries
- Extremity compartment syndrome
- REBOA
- Abdominal aortic injury
- Massive hemothorax
SCC Topics
- Advanced ventilator management
- Antibiotic management
- ICU delirium
- Nutrition – ASPEN guidelines
- Surgical feeding access
- Severe pancreatitis and complications
- ECMO
- Cardiac arrhythmias
- Cardiogenic shock, PACs, and bedside echo
- ARDS
- Coagulopathy, ROTEM/TEG and resuscitation
- Seizure
- Acute renal failure and RRT
- Urogenital tract injuries
- Prehospital transportation and care
- Pain management – multimodal, regional blocks and catheters
University of Utah Health Critical Care Ultrasonography (UUHCCUS) Curriculum
- Intro: Introduction to Ultrasonography
- Unit 1: Basic Principles
- Unit 2: Hands-On Practice
- Unit 3: Thoracic (Lung & Pleural) Ultrasonography
- Unit 4: Basic Critical Care Echocardiography
- Unit 5: Cardiac Pathologies
- Unit 6: FAST & RUSH Exams
- Unit 7: Cardiac Arrest & Volume Assessment
- Unit 8: Advanced Critical Care Echocardiography
- Unit 9: Vascular Ultrasonography (Abdominal Aorta & DVT Evaluation)
- Unit 10: Vascular Ultrasonography (Vascular Access)
- Unit 11: Abdominal Ultrasonography (Gallbladder, Common Bile Duct, & Bowel/Appendix)
- Unit 12: Abdominal Ultrasonography (Kidneys & Bladder)
The Surgical Critical Care Fellowship Program offers fellows a variety of research opportunities depending on their interests. Below is a selection of previous fellow publications and research.
- Surgical Capacity Building in Low- and Middle-Income Countries: Lessons for Thoracic Surgery - Koch R, Felsted AM, Virk S, Roy N, Jayaraman S
- The Effect and Feasibility of mHealth-Supported Surgical Site Infection Diagnosis by Community Health Workers After Cesarean Section in Rural Rwanda: Randomized Controlled Trial - Kateera F, Riviello R, Goodman A...Koch R, Hedt-Gauthier B
- Does community-based health insurance protect women from financial catastrophe after cesarean section? A prospective study from a rural hospital in Rwanda - Koch R, Nkurunziza T, Rudolfson N, Kateera F
- Rib Fractures and Delayed Pleural Space Complications - Kryskow M
- Palliative care and the modern-day surgeon - Tam S
- Age Is a Barrier to Surgical Stabilization of Rib Fracture in Patients with Flail Chest - Kryskow M
- Stop flailing: The impact of bicortically displaced rib fractures on pulmonary outcomes in patients with chest trauma — an American Association for the Surgery of Trauma multi-institutional study - Senekjian L, Birkas Y, Buhavac M...Colonna A, Ennis T, McCrum M, Nunez J, Young J, Nirula R
- Novel Approach to Reduce Transmission of COVID-19 During Tracheostomy - Foster P, Cheung T, Craft P, Kryskow M, DiSiena M
- Right Ventricular Involution: Big Changes in Small Hearts - Bowen ME, Selzman CH, McKellar SH
- Critical Illness Polyneuropathy and Myopathy: An Underappreciated Foe - Bacon AW
The Surgical Critial Care Surgery Fellowship Program follows all institutional policies as outlined by the University of Utah GME Office, including those pertaining to salary, leave, program responsibilities, and more. To see current university policies, visit the GME policy website.
ROTATION INFORMATION
Clinical rotations take place at University of Utah Health, Primary Children’s Medical Center, Intermountain Medical Center, and the Veterans Affairs Medical Center. During clinical rotations fellows evaluate new patients and manage patients under treatment, including the simulation and treatment planning, while under appropriate supervision. Fellow progress is evaluated on an individual basis following the completion of each clinical rotation and by the program director on a quarterly basis.
- Develop expertise in the management of critically ill surgical patients.
- Enhance clinical decision-making skills for the management of complex surgical cases.
- Acquire advanced knowledge and skills in ventilatory management and respiratory support.
- Gain expertise in hemodynamic monitoring and management.
- Develop effective communication and teamwork skills in a multidisciplinary critical care setting.
- Collaborate with ICU teams, including attending surgeons, nursing staff, respiratory therapists, and other healthcare professionals, to provide comprehensive and coordinated care.
- Participate in daily rounds and contribute to the development of management plans for critically ill surgical patients.
- Demonstrate effective communication skills while interacting with patients and their families, providing clear explanations, and obtaining informed consent for procedures and interventions.
- U of U Hospital Surgical Intensive Care Unit (3 months)
- U of U Hospital Cardiovascular Intensive Care Unit (3 months)
- Veterans Affairs Medical Center Surgical Intensive Care Unit/Echocardiography (2 months)
- Intermountain Medical Center Shock Trauma Intensive Care Unit (1 month)
- U of U Hospital Neuro Critical Care Unit (1 month)
- Primary Children's Medical Center Pediatric Intensive Care Unit (2 weeks)
- U of U Hospital Anesthesiology (0.5 month)
- U of U Hospital Burn Trauma Intensive Care Unit AND/OR Elective (1 month)
More information on individual rotation site objectives can be found below in the "STRUCTURE" section.
DUTY HOURS
Work hours are to be logged via MedHub daily. The Division of General Surgery is committed to ensuring full compliance with the resident duty hour policies set forth by the GME office. All fellows will have at least one full 24-hour period per week without clinical duties. Additionally, fellows’ work hours are to be limited to an average of less than or equal to 80 hours per week during each 4-week block beginning the first day of the month and for the entire month. Fellows’ schedules should ensure that all fellows have greater than 10 hours off between all shifts and clinical on-call duties must be compliant with the 24+4 hour requirement mandated by the GME office. Work hour violations can nearly always be anticipated, and it is the responsibility of the fellow to notify supervisors if there will be violations. Fellows are responsible for organizing their schedules and ensuring vacations and meetings are scheduled such that the above policy can be fulfilled. The schedule should incorporate the actual hours of clinical responsibility to facilitate timely departure from the hospital. Schedules are to be reviewed by the PD prior to publication. Program leadership is to be notified in advance if conflicts arise that do not allow fellow coverage of clinical obligations as outlined above.
CALL
Fellows will be expected to take general surgery/trauma call during their SCC year if they have completed a general surgery residency program. Fellows that are not eligible to take this call will still be expected to take SICU call.
PROGRAM STRUCTURE
The below information outlines the learning objectives, clinical duties, and other expectations for each rotation site. The structure of each rotation is determine by program leadership. Fellows will be expected to meet all necessary learning requirements to progress. Individual fellow progress is evaluated following the completion of each clinical rotation and by the program director quarterly.
LEARNING OBJECTIVES: 3 MONTHS
- Develop expertise in the management of critically ill surgical patients in the SICU: Gain an understanding of the principles of critical care management, including hemodynamic monitoring, ventilatory support, and fluid resuscitation. Learn to recognize and manage common surgical critical care conditions, such as sepsis, acute respiratory distress syndrome (ARDS), and multiple organ dysfunction syndrome (MODS). Understand the principles of nutritional support and metabolic management in critically ill surgical patients. Develop proficiency in utilizing evidence-based protocols and guidelines for optimal care in the SICU.
- Enhance clinical decision-making skills for the management of complex surgical cases in the critical care setting: Participate in the daily management and decision-making for critically ill surgical patients admitted to the SICU. Develop proficiency in interpreting and integrating data from various monitoring modalities, laboratory tests, and imaging studies to guide patient management. Learn to prioritize interventions and make timely decisions for surgical procedures, imaging studies, and consultations in critically ill patients. Gain expertise in recognizing and managing complications related to surgical procedures, such as post-operative bleeding, anastomotic leaks, and surgical site infections.
- Acquire advanced knowledge and skills in ventilatory management and respiratory support: Understand the indications, contraindications, and management principles of mechanical ventilation in critically ill surgical patients. Learn to interpret and adjust ventilator settings based on patient physiology, lung mechanics, and oxygenation parameters. Develop proficiency in managing patients requiring non-invasive ventilation, high-frequency oscillatory ventilation, or extracorporeal membrane oxygenation (ECMO). Participate in multidisciplinary discussions regarding difficult ventilator weaning and extubation decisions.
- Gain expertise in hemodynamic monitoring and management: Understand the principles and interpretation of invasive hemodynamic monitoring, including central venous pressure (CVP), pulmonary artery catheterization, and arterial pressure monitoring. Develop skills in assessing fluid states and volume resuscitation in critically ill surgical patients. Learn to recognize and manage hemodynamic instability, including shock states, hypovolemia, and cardiac dysfunction. Gain proficiency in utilizing vasoactive medications and inotropic support to optimize hemodynamic parameters.
CLINICAL RESPONSIBILITIES
The SICU is an open unit, meaning that the surgical teams remain the primary teams and the SICU team is technically a consulting team and is responsible for the critical care of the patient. The surgical teams will manage their own drains, tubes, and dressings. The primary team is responsible for writing basic admission orders. After admission, the SICU team writes ALL other orders. Why, you ask? Because the SICU team needs to know when a patient is leaving the unit for a study, if labs are being drawn so the team can follow up on them appropriately, so there is streamline communication between the SICU team and the bedside nurse, so as to minimize the number of cooks in the kitchen.
LEARNING OBJECTIVES: 3 MONTHS
Develop expertise in the management of critically ill patients with cardiovascular conditions in the CVICU
- Gain a comprehensive understanding of the pathophysiology, diagnosis, and management of common cardiovascular conditions encountered in the CVICU, including myocardial infarction, heart failure, arrhythmias, and post-operative cardiac care.
- Learn to interpret and integrate data from invasive hemodynamic monitoring, electrocardiograms (ECGs), echocardiograms, and other diagnostic tests specific to cardiovascular critical care.
- Understand the principles of mechanical circulatory support, such as intra-aortic balloon pump (IABP) and ventricular assist devices (VADs), and their indications, contraindications, and management.
Enhance clinical decision-making skills for the management of complex cardiovascular cases in the critical care setting
- Participate in the daily management and decision-making for critically ill patients admitted to the CVICU, including those recovering from cardiac surgery, heart transplantation, or other interventional procedures.
- Develop proficiency in assessing and managing hemodynamic instability, including optimizing fluid resuscitation, vasoactive medication titration, and vasopressor support.
- Gain expertise in recognizing and managing complications specific to cardiovascular surgery, such as bleeding, cardiac tamponade, acute graft dysfunction, or valve dysfunction.
- Learn to anticipate and manage post-operative complications and challenges, such as arrhythmias, fluid and electrolyte imbalances, and infection.
Acquire advanced knowledge/ skills in ventilatory management and respiratory support for cardiovascular critical care
- Understand the unique considerations in ventilatory management for patients with cardiovascular compromise, including those with acute respiratory distress syndrome (ARDS), cardiogenic pulmonary edema, or concomitant lung pathology.
- Learn to interpret and adjust ventilator settings based on patient physiology, lung mechanics, oxygenation, and hemodynamic parameters.
- Develop proficiency in managing patients requiring advanced respiratory support techniques, such as positive end-expiratory pressure (PEEP), prone positioning, or extracorporeal membrane oxygenation (ECMO).
- Participate in multidisciplinary discussions regarding weaning strategies and extubation decisions for cardiovascular patients.
Enhance knowledge and skills in invasive monitoring and hemodynamic management specific to cardiovascular critical care
- Gain expertise in utilizing invasive hemodynamic monitoring, including arterial lines, central venous catheters (CVCs), and pulmonary artery catheters, to assess and optimize cardiac function and tissue perfusion.
- Learn to interpret and integrate data from invasive monitoring devices, including cardiac output, mixed venous oxygen saturation (SvO2), and systemic vascular resistance (SVR).
- Develop proficiency in managing hemodynamic instability, optimizing preload, afterload, and contractility, and adjusting vasoactive medications accordingly.
- Participate in the management of patients requiring mechanical circulatory support devices, such as IABP or VADs, and their associated monitoring and complications.
LEARNING OBJECTIVES; 1 MONTH
Develop expertise in the comprehensive management of critically ill burn patients
- Gain a comprehensive understanding of the pathophysiology, classification, and management of thermal, chemical, and electrical burns.
- Learn to assess the extent and depth of burn injuries using established methods, such as the rule of nines and Lund-Browder charts.
- Understand the principles of initial burn resuscitation, wound care, infection control, nutritional support, and pain management specific to burn patients.
- Become familiar with the principles and techniques of burn reconstruction and rehabilitation.
Enhance clinical decision-making skills for the management of complex burn cases in the critical care setting
- Participate in the comprehensive assessment and ongoing management of critically ill burn patients admitted to the BTICU, including those with extensive burn injuries, inhalation injuries, or associated trauma.
- Develop proficiency in conducting burn wound evaluations, assessing burn depth, and assessing for complications such as infection, compartment syndrome, or systemic inflammatory response syndrome (SIRS).
- Learn to prioritize interventions and make timely decisions for surgical procedures, wound debridement, escharotomy, fasciotomy, and other burn-related procedures.
- Gain expertise in managing complications associated with burn injuries, such as acute respiratory distress syndrome (ARDS), sepsis, renal failure, and hypermetabolic response.
Acquire advanced knowledge and skills in burn-specific critical care interventions and technologies
- Understand the principles and techniques of burn resuscitation, including fluid resuscitation formulas, monitoring of urine output, and adjustments based on clinical response and hemodynamic parameters.
- Develop proficiency in the use of specialized monitoring techniques in burn patients, such as invasive hemodynamic monitoring, intra-compartmental pressure monitoring, and non-invasive monitoring of burn wound perfusion.
- Gain expertise in the use of adjunctive therapies specific to burn patients, including inhalation therapies, topical antimicrobial agents, pain management strategies, and nutritional support tailored to burn-related metabolic demands.
- Become familiar with advanced wound care techniques (grafting, tissue engineering, and negative pressure wound therapy).
Acquire knowledge of the long-term management and rehabilitation of burn patients.
- Gain an understanding of the long-term sequelae of burn injuries, including scar management, contractures, functional limitations, and psychological challenges.
- Become familiar with the principles and techniques of burn rehabilitation, including physical and occupational therapy, psychological support, and social reintegration.
- Participate in multidisciplinary discussions regarding the transition of care from the BTICU to burn outpatient clinics or rehabilitation centers and collaborate in the development of comprehensive care plans for burn survivors.
LEARNING OBJECTIVES: 1 MONTH
Develop expertise in the management of critically ill patients with acute neurological conditions in the NCCU
- Gain a comprehensive understanding of the pathophysiology, diagnosis, and management of common neurological emergencies encountered in the NCCU, such as traumatic brain injury (TBI), ischemic and hemorrhagic strokes, status epilepticus, and neuromuscular disorders.
- Learn to recognize and manage complications specific to neurological conditions, including increased intracranial pressure, seizures, cerebral edema, and spinal cord injury.
- Understand the principles of neurocritical care, including neuroprotective strategies, neuroimaging interpretation, and monitoring techniques for neurological monitoring.
Enhance clinical decision-making skills for the management of complex neurological cases in the critical care setting
- Participate in the comprehensive assessment and ongoing management of critically ill patients with acute neurological conditions admitted to the NCCU, including those with altered mental status, focal neurological deficits, or neurosurgical emergencies.
- Develop proficiency in conducting detailed neurological examinations, interpreting neuroimaging studies (such as CT scans, MRI, and angiograms), and integrating clinical and radiological findings to guide management decisions.
- Learn to prioritize interventions and make timely decisions for neurosurgical procedures, neurointerventional therapies, medical treatments, and consultation with neurology and neurosurgery subspecialties as needed.
- Gain expertise in managing complications associated with acute neurological conditions, such as intracranial infections, venous thromboembolism, hydrocephalus, and autonomic dysregulation.
Acquire advanced knowledge/skills in neuro-monitoring and neuroresuscitation for critically ill neurological patients
- Understand the principles and interpretation of neuro-monitoring techniques used in the NCCU, including intracranial pressure monitoring, cerebral perfusion pressure calculation, continuous electroencephalography (cEEG), and neuromuscular monitoring.
- Develop proficiency in assessing and managing neurologic instability, including optimization of cerebral perfusion, management of intracranial hypertension, and prevention of secondary brain injury.
- Gain expertise in the use of advanced therapeutic modalities in neurocritical care, such as hypothermia, induced hypertension, osmotherapy, and seizure management.
- Participate in multidisciplinary discussions regarding the use of neuroimaging, neurophysiological testing, and advanced neurointerventional procedures in the management of critically ill neurological patients.
LEARNING OBJECTIVES: 2 WEEKS
- Develop proficiency in airway assessment: Learn to systematically assess patients' airways, identifying potential difficulties and anatomical variations. Understand the predictors of difficult intubations, such as the Mallampati score, thyromental distance, and cervical range of motion.
- Master intubation techniques : Gain expertise in performing endotracheal intubations using direct laryngoscopy, including proper blade selection, laryngeal exposure, and tube placement. Learn about alternative intubation techniques, such as video laryngoscopy and fiberoptic intubation.
- Acquire skill in Rapid Sequence Intubation: Understand the indications and contraindications for RSI. Develop proficiency in administering induction agents, neuromuscular blockers, and properly timed ventilation for optimal intubation conditions.
- Learn techniques for intubating difficult airways: Gain expertise in managing difficult airways through advanced techniques such as bougie-assisted intubation, use of supraglottic airways, and awake intubation. Understanding the principles of cricothyrotomy and surgical airway access for extreme cases.
- Understand intubation-related complications and management: Learn to recognize and manage complications that may arise during intubation, such as desaturation, aspiration, and hypotension. Understand how to troubleshoot difficult ventilation scenarios after intubation.
- Gain exposure to special scenarios: Observe and actively participate in intubations for different surgical procedures, patient populations (e.g., obese patients, trauma patients), and emergent situations. Understand the considerations for intubating patients with known difficult airways or anatomical challenges.
- Acquire knowledge of airway anatomy and physiology: Gain a deep understanding of airway anatomy, including the structures of the upper airway and tracheobronchial tree. Learn about the physiology of ventilation, oxygenation, and gas exchange, and how it relates to intubation and airway management.
- Develop a systematic approach to intubation: Learn a step-by-step approach to intubation, including pre-intubation assessment, preparation of equipment, patient positioning, and post-intubation care. Understand the importance of continuous monitoring and documentation during and after intubation.
- Integrate intubation skills in critical care: Recognize the significance of intubation skills in the critical care setting, particularly in cases of airway compromise or impending respiratory failure. Apply the techniques and principles learned on the anesthesiology rotation to optimize airway management of critically ill surgical patients in the ICU setting.
CLINICAL RESPONSIBILITIES
Fellows will be assigned to the OR Monday through Friday (no weekends). Special consideration will be given to select appropriate teaching cases for all trainees. The coordinator will assign fellows to a room by late afternoon the day prior to their cases (around 1500). It is the fellows' responsibility to look up their assignments at the OR front desk. After reviewing their cases and patients, fellows must call or text the attending/resident the evening prior to 1800 to discuss the anesthetic plan and the time they should arrive. If fellows are unable to reach the attending or resident, they should arrive at the OR by 0645.
Fellows should prepare for each of their patients the night prior. They can view the OR schedule in Epic by navigating to the status board in the upper left-hand corner and selecting the "Main OR" button. Fellows should review patient medical records in Epic and consider the anesthetic implications of the patients' comorbidities. For each case, fellows should consider what type of anesthetic would be best for the type of surgery planned and the specific patient. Fellows should then form an anesthetic plan and discuss their concerns and suggestions with the attending or resident. Unless encouraged to do otherwise, fellows should stay in the OR throughout the procedure. If fellows' patients are admitted, fellows should see them post-operatively to determine any anesthesia-related complications.
Successful completion of the two-week anesthesiology rotation requires self-motivation. As advanced GME trainees, fellows should be familiar enough with clinical medicine and the OR to be able to identify learning opportunities on their own. Fellows can make the most of the rotation by assisting in as many different kinds of cases and in as many different subspecialties as they can.
Note: Fellows are not expected to take call during this rotation. However, no more than two absences are permitted during the two-week rotation. If fellows will miss, or miss, more than two days, the rotation will need to be rescheduled.
CONFERENCES
- Fellows should plan to attend Grand Rounds or didactic conferences on Wednesday mornings at 0630.
- Peri-operative Echocardiography Conference: Fellows are welcome to attend peri-operative echocardiography conferences on Thursday mornings at 0630. If they wish to do so, they must coordinate this with the attending or resident since they would be late for the OR.
- Journal Club: If there is a Journal Club scheduled during the rotation, fellows are invited to attend. They will receive an email with the information, and it will also be included in fellows' calendar.
LEARNING OBJECTIVES: 2 MONTHS
Develop expertise in managing critically ill surgical patients in the SICU, with a focus on veterans' specific healthcare needs
- Gain a comprehensive understanding of common surgical conditions and post-operative management in veterans, including trauma, complex surgical procedures, and surgical complications related to comorbidities.
- Recognize and address unique challenges in the care of veteran patients, such as the management of blast injuries, combat-related trauma, and specific service-related health concerns.
- Understand and navigate the resources available within the Veterans Affairs healthcare system to provide comprehensive care for veterans.
Acquire expertise in the management of comorbid conditions and unique healthcare needs of veteran patients in the SICU
- Understand the impact of military service-related conditions, such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and substance abuse, on the care of critically ill surgical patients.
- Develop proficiency in the management of complex wounds, including combat-related injuries, surgical site infections, and pressure ulcers.
- Collaborate with multidisciplinary teams, including social workers, mental health professionals, and rehabilitation specialists, to provide comprehensive care and facilitate successful transitions to post-SICU care for veteran patients.
Acquire advanced knowledge/skills in echocardiography for evaluation and management of critically ill surgical patients
- Learn the principles of transthoracic echocardiography (TTE) and gain proficiency in performing basic echocardiographic assessments, including cardiac structure and function evaluation, assessment of ventricular systolic and diastolic function, and identification of valvular abnormalities.
- Understand the indications and limitations of TTE in the SICU, including its role in assessing cardiac function, volume status, and guiding hemodynamic management.
- Gain exposure to advanced echocardiographic techniques, such as transesophageal echocardiography (TEE), for the assessment of complex cardiac pathologies and intraoperative monitoring.
- Collaborate with cardiology and echocardiography specialists to enhance interpretation skills and refine echocardiography reporting.
- Perform 50 supervised echocardiograms and review 100 echocardiography studies.
LEARNING OBJECTIVES: 1 MONTH
Develop expertise in the comprehensive management of critically ill shock/trauma patients in the STICU
- Gain a comprehensive understanding of the pathophysiology, diagnosis, and management of common medical conditions encountered in the STICU, such as sepsis, respiratory failure, acute kidney injury, and acute cardiovascular events.
- Learn to recognize and manage medical emergencies and complications, including electrolyte imbalances, diabetic emergencies, status epilepticus, and drug overdose.
- Understand the principles of resuscitation, early goal-directed therapy, and evidence-based guidelines for the management of shock/trauma conditions in the critical care setting.
Enhance clinical decision-making skills for the management of complex shock/trauma cases in the STICU
- Participate in the comprehensive assessment and ongoing management of critically ill shock/trauma patients admitted to the STICU, including those with hemodynamic instability, acute respiratory failure, or multi-organ dysfunction.
- Develop proficiency in conducting thorough clinical evaluations, including history taking, physical examinations, interpretation of laboratory and imaging studies, and integration of hemodynamic and organ function data.
- Learn to prioritize interventions and make timely decisions for diagnostic procedures, appropriate antimicrobial therapy, and consultation with subspecialists as needed.
- Gain expertise in managing medical complications, such as ventilator-associated pneumonia, deep vein thrombosis, gastrointestinal bleeding, and delirium.
LEARNING OBJECTIVES: 2 WEEKS
Develop an understanding of the unique aspects of critical care management in pediatric patients
- Gain knowledge of the physiological differences between pediatric and adult patients and their implications for critical care management.
- Understand the specific diseases and conditions commonly encountered in the PICU, such as respiratory distress syndrome, sepsis, congenital heart disease, and traumatic injuries.
- Learn about the age-specific considerations in pediatric critical care, including growth and development, psychosocial aspects, and family-centered care.
Gain an understanding of the management of pediatric cardiac and surgical patients in the critical care setting
- Learn about the principles of pediatric intensive care, including the management of congenital heart defects, post-operative patients, and hemodynamic monitoring specific to pediatric patients.
- Understand the surgical considerations and peri-operative management for pediatric patients undergoing surgical procedures in the PICU.
- Gain exposure to the care of children with traumatic injuries, including the management of head trauma, abdominal trauma, and orthopedic injuries in the critical care setting.
APPLY TO THE PROGRAM
To be eligible for the one-year SCC Fellowship, an applicant must have completed at least three clinical years in an ACGME accredited residency program, an American Osteopathic Association approved residency program, a program with ACGME International Advanced Specialty Accreditation, or a Royal College of Physicians and Surgeons of Canada accredited or College of Family Physicians of Canada accredited residency program located in Canada in one of the following specialties prior to their start date: anesthesiology, emergency medicine, neurological surgery, obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, surgery, thoracic surgery, vascular surgery, or urology.
If applying for the two-year SCC/ACS Fellowship, an applicant must have completed an ACGME accredited general surgery residency program in the United States or Canada.
Additionally, the fellow must meet all the requirements contained in the “Eligibility and Credentialing of House staff” Policy of the University of Utah Office of Graduate Medical Education (GME), including:
- Being eligible for and obtaining a license to practice medicine in the state of Utah.
- Completion of all United States Medical Licensing Examination (USMLE) examinations.
- Graduation from a U.S. or Canadian medical school accredited by the Liaison Committee on Medical Education (LCME).
OR
- Graduation from a college of osteopathic medicine in the United States accredited by the AOA OR
- Graduation from a medical school outside of the United States and meets one or more of the following qualifications:
- Has a currently valid Educational Commission for Foreign Medical Graduates (ECFMG) certificate OR
- Has a full and unrestricted license to practice medicine in U.S. licensing jurisdictions OR
- Is a graduate of a medical school outside of the United States and has completed a Fifth Pathway program provided by an LCME-accredited medical school
- Passing a criminal background check
- Compliance with the Health Sciences Center Drug Testing
You can obtain more information regarding the GME policies and benefits, along with general information, at the GME website.
Eligible applicants apply through the Surgical Critical Care and Acute Care Surgery Fellowship Application Service. Applications are screened and then reviewed by the Program Director and a diverse group of at least four faculty members and selected applicants are invited to interview. Candidates will then be evaluated on their standing within their residency program, educational qualifications, academic productivity (grants, publications, degrees, and experience), interviews, and letters of recommendation. Selected fellows are matched via the National Resident Matching Program and are sent an offer letter.
ADDITIONAL REQUIRED INFORMATION
- Personal statement
- Curriculum Vitae
- Three letters of recommendation
- USMLE and ABSITE Scores
Check back later for deadlines for the 2025 application season!
OUR FELLOWS
Residency: General Surgery, Tulane University School of Medicine
Medical Degree: Cairo University School of Medicine
Residency: General Surgery, Harbor-UCLA Medical Center
Medical Degree: Loma Linda University
2023-2024
Ariel Rodgers, MD
Practice: University of Utah, UT
2023-2024
Jennifer Belzer, MD
Practice: University of Utah, UT
2022-2023
Karin Gunther, DO
Practice: HCA Florida Bayonet Point, FL
2022-2023
Tyler Pender, MD
Practice: Malamulo Adventist Hospital, Malawi, Africa
2021-2022
Rachel Koch, MD
Practice: UCSF Health, CA
2021-2022
Samuel South, MD
Practice: UC Health, CO
2020-2021
Sophia Tam, MD
Practice: Northwell Health, NY
2020-2021
Mark Kryskow, DO
Practice: Berkshire Health Systems, MA
2019-2020
Anthony Bacon, MD
Practice: Intermountain Healthcare, UT
2019-2020
Megan Bowen, MD
Practice: Sanford Health, ND
2018-2019
Bradley Kuhn, MD
Practice: Northeast Georgia Health System, GA
2018-2019
Athanasios Bramos, MD
Practice: University of Toledo, OH
2017-2018
Miloš Buhavac, MD
Practice: Texas Tech University Health Sciences Center, TX
2017-2018
Ronald Buczek II, DO
Practice: Woodlands Hand to Shoulder Foot and Ankle Center, TX
2016-2017
Elizabeth Chabot, MD
Practice: Intermountain Healthcare, UT
2016-2017
Amber Jones, DO
Practice: Kern Medical, CA
2015-2016
Claire Pederson, MD
Practice: UC Health, CO
2015-2016
John Skaggs, MD
Practice: University of Utah, UT
2014-2015
Janice Yeung, MD
Practice: Surgical Affiliates Management Group, Inc, CA
2013-2014
Joe Uccelli, MD
Practice: Western Surgical Group, NV
2012-2013
Grant Erickson, MD
2011-2012
Sarah Menacho, MD
2010-2011
John Sutherland, MD
2009-2010
Evan Moore, MD
2008-2009
Chad Cole, MD
2007-2008
Matthew Sorrell, MD
2006-2007
Thomas White, MD
FACULTY
- Alexander Colonna, MD, MSCI, FACS
- Toby Enniss, MD, MBA, FACS
- Matt Griffee, MD
- Joanna Grudziak, MD, MPH
- Sudha Jayaraman, MD, MSc, FACS
- Sarah Lombardo, MD, MSC
- Peter Liu, MD
- Marta McCrum, MD, MPH
- Sean Overton, MD
- Caroline Ruminski, MD
- Jason Young, MD, PharmD, FACS
CONNECT WITH US
Alexander Colonna, MD, MSCI, FACS, Fellowship Director
Learn more about Dr. Colonna
Joanna Grudziak, MD, MPH, Associate Program Director
joanna.grudziak@utah.edu
Tonya Pickron, MEd, BA, Program Manager
tonya.pickron@hsc.utah.edu