Pediatric Surgical Critical Care Fellowship Program

Upon completion of the Surgical Critical Care fellowship, the fellow should be able to: (1) provide safe, effective, and evidence based critical care to neonates, infants, children, and adolescents from all surgical sub-specialties within a pediatric intensive care unit; (2) provide safe, effective, and evidence based critical care to adults in an adult ICU, Cardiac ICU, Burn ICU; (3) teach and conduct research in pediatric surgical critical care, and (4) be eligible for the examination in Surgical Critical Care administered by the American Board of Surgery. The educational goals and objectives of the surgical critical care residency are organized according to the six core competencies emphasized by the ACGME (Accreditation Council for Graduate Medical Education). These goals will serve as the basis for resident teaching as well as performance evaluations.

The global objective of the surgical critical care fellowship program is to teach residents the skills necessary to become well-rounded surgical critical care specialist. In addition, it is our interest to align our training program with modern career objectives in acute care surgery: trauma, burn, and emergency general surgery. The rotation schedule for the residency is designed to achieve this global objective, while at the same time permitting enough flexibility within the program to accommodate the desire of the resident to focus on a particular area of interest. The PSCC fellow while on call will function as the senior pediatric surgery fellow with all its attendant responsibilities.

The fellow's time will be divided between the Burn, Cardiovascular Intensive Care Unit (CVICU), Pediatric Intensive Care Unit (PICU), Surgical Intensive Care Unit (SICU) services.

Pediatric Intensive Care Unit (PICU)

The Critical Care Fellow (CCF) will rotate in the Pediatric Intensive Care Unit at The Children's Hospital of Colorado as a member of the Pediatric Surgery/Pediatric ICU Team. This rotation will focus on critical care issues related to children in the setting of trauma; thermal / inhalation injury; and postoperative general surgery, neurosurgery, orthopedic surgery, transplant surgery. Emphasis will be placed on ventilator and hemodynamic support, fluid and electrolyte management, and nutritional support. The CCF will gain an understanding of the age specific requirements of pediatric critical care through participation in daily ICU rounds with the pediatric surgery fellow, general surgery residents, pediatric critical care fellow, pediatric critical care resident, and the attending pediatric surgeons / pediatric intensivists. The CCF should be prepared to direct the management of the pediatric surgical critical care service, including the education of surgical residents and medical students on surgical clerkship.

Surgical Intensive Care Unit (SICU)

The critical care resident (CCF) will assume a direct role in the design and execution of treatment plans when on the SICU rotations. The CCF will perform or observe intensive care unit procedures including airway control; bronchoscopy; central venous, pulmonary artery; and peripheral arterial line placement, tube thoracostomy, thoracentesis, arteriovenous hemofiltration, and arteriovenous rewarming. The CCF may teach and assist residents with procedures with the supervision of the attending physician. Each general surgery attending retains ultimate responsibility for the management of their patients admitted to the intensive care unit. The CCF will interact with each of the attending surgeons, enabling him/her to learn various styles of critical care management. The CCF, in conjunction with the admitting general surgical team, will formulate and contribute to all diagnostic and treatment plans. The CCF will also interact with the general surgery residents in a discussion/teaching capacity during daily checkout rounds and work rounds. The CCF is responsible for conducting daily rounds with the ICU based residents, and his/her responsibilities will include patient assessment and assuring that appropriate treatment plans are designed and carried out. The CCF will also be expected to attend teaching and patient care conferences, and to organize the weekly Critical Care Teaching Conference.

Cardiovascular Intensive Care Unit (CVICU)

The goal of the rotation on the Cardiothoracic Intensive Care rotation is to develop a clear understanding of pre and post-operative management of the cardiac surgical patient. Emphasis will be placed on the pathophysiology and support of heart failure including ECMO and / or cardiac transplantation. The pathophysiology and medical / surgical treatment of cyanotic and non-cyanotic congenital heart disease; diagnosis and treatment of arrhythmias and use of vasoactive medications in the ICU setting will be also emphasized. The CCF will function as an integral member of the cardiothoracic service in conjunction with the cardiothoracic surgery fellow, the cardiology fellows, and attending cardiothoracic surgeons / pediatric cardiologists. Responsibilities will include attending daily rounds in the CICU, formulating and executing critical interventions, and monitoring patients. In addition, the CCF will be expected to attend multidisciplinary patient care and teaching conferences.

Burn Unit

The goal of the Burn Unit rotation, which will take place at the University of Colorado Hospital, is to develop an understanding of the current concepts of burn pathophysiology and apply this information in the evaluation, resuscitation, clinical management, and rehabilitation of the burned patient. Emphasis will be placed on burn resuscitation and physiology, ventilator management in the setting of systemic inflammation accompanying burns and thermal airway injury, and nutritional support. The CCF will function as an integral component to the burn service in conjunction with the general surgery resident on the burn service and the burn attending. Responsibilities will include attending daily rounds in the burn unit, formulating and executing critical interventions, and monitoring patients. In addition, the CCF will be expected to attend multidisciplinary patient care and teaching conferences.

Length of Program: 1 year

Number of Positions: 1 per year

It is our ultimate goal to prepare our fellows not only to satisfactorily pass the ABS certification examination, but to excel beyond that to a level of expertise that will allow the fellow to become a future leader in their area of specialty. To assist in this endeavor, we have many educational activities which include:

• Pediatric Surgery Grand Rounds Conference
• Pediatric Surgery SCORE Curriculum Conference
• Surgical Gastrointestinal Conference
• Subspecialty Conference
• Surgical Critical Care Conference
• Surgery Pathology Radiology Conference
• Journal Club Conference
• Case Presentation Conference
• Research Conference
• Morbidity and Mortality Conferences
• Multidisciplinary Trauma Lecture Series
• Department of Pediatrics Grand Rounds
• Neonatal Grand Rounds Conference
• Department of Surgery Grand Rounds
• General Surgery Residency Core Curriculum Conference
• Department of Surgery Biology Dialogues
• Research opportunities allowing residents exposure to national meetings
  

Applications should be made through the SCC and ACS Fellowship Application Service (SAFAS) by completing the appropriate forms and submitting the required supporting material. After review of this material, candidates are selected for in-person interview. Our interview season runs from June through September. Candidates will be contacted by e-mail regarding their application status. Pediatric Surgical Critical Care then matches with one fellow candidate each October, who will begin a one-year fellowship rotation the following August.

Candidates must have successfully completed an ACGME-accredited General Surgery Residency. We will also consider applicants who are currently enrolled in an accredited program and will have completed their third year of residency. We have no minimum USMLE Step I score requirement; however, scores above the 220 level are advantageous. We require three letters of recommendation and accept no more than four.

To apply, please send an updated CV, personal statement, and three letters of recommendation to Jaymie Donner (jaymie.donner@cuanschutz.edu). Please contact Mrs. Donner with any questions.

Fellows in our program must be a U.S. citizen or lawful permanent resident to train at the University of Colorado School of Medicine.

Questions about the fellowship program can be directed to Jaymie Donner: