Surgical critical care fellowship

The Spectrum Health/Michigan State University Surgical Critical Care Fellowship is a one-year ACGME-accredited program. The fellowship aims to train individuals in a broad range of disciplines essential to the care of the critically ill and injured patient, with two fellowship positions per year. The surgical intensive care unit at Spectrum Health Butterworth Hospital serves as the main site of clinical rotations. Fellows will be exposed to an extensive variety of patients including general surgery, trauma and severe traumatic brain injuries, burn, surgical oncology, vascular surgery, ENT oncology, orthopedics and thoracic.

Fellows receive significant experience in invasive procedures including central line placement, chest tube placement and intubation, bronchoscopy, percutaneous gastrostomy tube placement and tracheostomy placement. Additionally, fellows will have the opportunity to maintain operative skills on the busy emergency general surgery service and participate in trauma resuscitations and operative interventions.

The Spectrum Health/Michigan State University surgical critical care fellowship is a one-year ACGME-accredited program, with two fellowship positions per year. The fellowship trains individuals in a broad range of disciplines essential to care of the critically ill and injured patient.

The 22-bed surgical intensive care unit at Spectrum Health Butterworth Hospital serves as the main site of clinical rotations. Fellows will be exposed to an extensive variety of patients including general surgery, trauma and severe traumatic brain injuries, burn, surgical oncology, vascular surgery, orthopaedics, otolaryngology and thoracic patients. Fellows will work with members of the division of acute care surgery, including 18 board certified surgical intensivists with diverse clinical backgrounds.

Additional rotations and experiences including cardiothoracic intensive care unit, ECMO, advanced airway and anesthesiology. Emergency general surgery, surgical nutrition and echocardiography are also included in the fellowship year.

Program Aims

• Provide the best possible education for surgical critical care fellows and ensure board certification is achieved
• Expose fellows to the greatest breadth of clinical material and learning opportunities as possible
• Build and maintain a culture of safety and excellence in patient care
• Assure that fellows are supported and work in an environment that is conducive to education and well being
• Foster the growth and development of fellows into independently practicing physicians
• Prepare fellows for a career in surgical critical care where they can thrive in any spectrum of settings, from academic to community based, and anywhere in between

Throughout the one-year clinical fellowship, fellows spend a significant amount of time providing care for critically ill surgical and trauma patients requiring intensive medical care. As an ACS verified level 1 trauma center, Spectrum Health Butterworth Hospital provides services to a variety of blunt and penetrating trauma patients. The hospital and trauma center are supported by an extensive EMS system and AeroMed flight program that extends clinical capabilities throughout the region. Serving as a tertiary and quaternary referral center, fellows will be exposed to a wide array of clinical care, innovation, and research initiatives spanning a population of over nine million. Butterworth Hospital is a 620-bed hospital with the highest number of trauma admissions and emergency general surgery operations in the state of Michigan.

Numerous patient populations are cared for including orthopedic, neurosurgery, cardiovascular, otolaryngology, burn, trauma, peripheral vascular, urology and general surgery patients. The blended intensive care unit structure provides the fellows with a unique opportunity to care for a variety of patients and to learn from a dedicated team of general and specialty surgeons. All critical care physicians are board certified in surgical or anesthesiology critical care. Additional rotations in the cardiothoracic intensive care unit aim to give the fellow exposure to heart and lung transplant patients, ECMO and assist device management.

The fellowship also provides each physician with significant experience in invasive procedures including central line placement, chest tube placement and intubation, bronchoscopy, percutaneous gastrostomy tube placement, and tracheostomy placement. Fellows will maintain operative skills on the busy emergency general surgery service and participate in trauma resuscitations and operative interventions.

In addition to clinical experience, the fellowship also provides significant experience in surgical nutrition and research. An integral part of the fellowship is experience in the areas of metabolic response to stress, shock, and multiple organ system failure. Under the guidance of two dedicated nutrition physicians, the fellow will gain experience with fluoroscopic nasojejunal tube placement and determining TPN and tube feed needs. Other rotations including echocardiography will allow the fellow to develop a basic understanding of bedside ECHO in shock and resuscitation. Advanced airway skills are also offered to enhance the fellow’s ability to manage more routine to complex airway situations. Other activities required of the fellow include contributions to Quality Improvement activities and clinical protocol development. Point of care ultrasound (POCUS) is well integrated into the fellowship curriculum.

Finally, each critical care fellow can serve as a resource and teacher for junior residents throughout the fellowship experience. The Surgical Intensive Care Unit (SICU) team is comprised of residents from many different specialties including general surgery, vascular surgery, neurosurgery, plastic surgery, emergency medicine, anesthesiology and obstetrics and gynecology. The fellow will work with and lead the multidisciplinary surgical critical care team consisting of and overseeing, residents, medical and nurse practitioner and physician assistant students. The practice is also supported by excellent advanced practice providers.

Didactics

Based upon the American Board of Surgery outline, fellows will have a dedicated weekly curriculum including question bank to prepare for the ABS Surgical Critical Care Examination. Weekly general surgery conferences including M&M are also attended. Other conferences include weekly SICU didactics, monthly ACS journal club, Trauma Performance Committee, SICU Morbidity and Mortality, as well as attendance to daily check in. Numerous opportunities to become involved in process and quality improvement exist for those that are interested. The fellowship year provides ample opportunity for study and preparation for the critical care board exam.

• First and second Friday of the block: SICU Fellow Lecture Series
• Third Friday of the block: Acute Care Surgery Journal Club
• Fourth Friday of the block: SICU Morbidity and Mortality Conference

Research

Under the leadership of the Trauma Research Institution, fellows have access to significant research support. The scholarly activity support team also offers biostatistics consultation, and poster preparation. Residents will be expected to submit their work for presentation at an institutional Research Day.

Applicants must complete an ACGME-accredited general surgery program and be eligible for the American Board of Surgery examination. Exceptional residents in their PGY3 year may also apply. The fellowship runs from August 1 through July 31 of the academic year. We accept all applications through Surgical Critical Care and Acute Care Surgery Fellowship Application Service (SAFAS) with interviews conducted June through August.

For more information on our program, contact Jennifer Bruno, program coordinator.

Spectrum Health provides a comprehensive and very competitive benefits package for our residents, staff and their families. In addition, our program provides educational monies to support your ongoing education. Download our salary and benefits document to learn more.