Division of Trauma and Surgical Critical Care
The University of Massachusetts offers a one-year surgical critical care fellowship program approved by the Residency Review Committee for Surgery through Accreditation Council for Graduate Medical Education. There is also a second optional year for trauma and acute care surgery, including minimally invasive surgery for the critically ill patient. The objectives of the postgraduate residency in surgical critical care are to prepare graduates of accredited general surgery residencies to take their surgical critical care board examinations and to become directors of a surgical intensive care unit. ln order to accomplish these objectives, the following areas of training are emphasized:
mastery of advanced technology and instrumentation for monitoring and supporting organ system function in critically ill patients
development of administrative managerial skills and advanced understanding of ethical, economic and legal issues pertinent to critical care medicine
UMass Medical Center has 36 ICU beds for trauma, general surgery, vascular, neurosurgery and other surgical specialties. There is a total of 1,200 admissions a year to the ICU, with an occupancy rate of 95 percent. There is also an eICU which is active and online 24h/7d and staffed by a team which consists of a critical care attending and a critical care mid-level practitioner which participates in the process of triage and admission for the surgical ICU patients and their daily monitoring and care of these patients as well as for emergency situations. There is a Critical Care Operations Committee that is very actively involved in all the ICUs including the medical ICUs which participates in the optimization of patient care and includes the drafting of ICU protocols and consideration of new treatments and monitoring modalities. The surgical ICUs strongly advocate the observance of Best Clinical Practice as demonstrated by clinical studies. The results of the participation of eICU and the implementation of Best Clinical Practice has resulted in observed mortality rates being lower than expected in the surgical ICUs.
The fellows have active participation in the clinical management of ICU patients both as practitioners in the ICU directly as well as participation as a member of the eICU team.. They have didactic responsibilities with the residents of surgery, anesthesia and emergency medicine who rotate through the ICU monthly. They are also expected to participate in different research projects. During the fellowship year they gather expertise and technical proficiency in addition to administrative skills required to become a first class ICU director and the ability to understand the operations of the eICU and participate in the development of an eICU. The program has a core curriculum of four didactic conferences every week in addition to weekly conferences of critical care morbidity and mortality rounds, journal club, and case presentations.
The second optional year for trauma, acute care surgery can be tailored to include research and laparoscopic surgery in the care and management of the critically ill ICU patient and/or the trauma patient, and several other additional areas associated with the Department of Surgery.