Surgical Critical Care
Name of Host Institution: Cincinnati Children’s Hospital Medical Center
Program Specialty / Subspecialty: Surgical Critical Care Fellowship
Program Mailing Address:
Cincinnati Children’s Hospital Medical Center
MLC 2023
3333 Burnet Ave.
Cincinnati, OH 45229-3039
Program Phone Number: 513-803-9226
Program Fax Number: 513-636-7657
Program Email: juan.gurria@cchmc.org
Program Director: Juan Gurria, MD
Alternate Program Contact: Meghan Wiesner, Program Coordinator, meghan.wiesner@cchmc.org
History
This program was approved by the Graduate Medical Education Committee in September 2022. The first trainee began in September 2022.
Duration
One year. Surgical Critical Care fellowship plus second year is optional and would include not only further training and expertise in pediatric trauma but also an opportunity to obtain a master’s degree as an additional component to the training. Subject to being offered by division chief and program director.
Prerequisite Training/Selection Criteria
The trainee will have completed a residency in general surgery and therefore be a candidate eligible for a pediatric surgical training program. It is also possible that such an individual will have already completed a general pediatric surgical training program. It is also possible that such an individual will have already completed a general pediatric surgical training program and now desire specialty training in surgical critical care.
Goals and Objectives
The Surgical Critical Care fellow at Cincinnati Children’s Hospital will learn how to manage the care of patients with acute critical illness in both pediatric and adult intensive care units. The fellow will spend nine months taking care of pediatric surgery patients in the pediatric, cardiovascular and neonatal intensive care units at Cincinnati Children’s Hospital and three months taking care of adult patients with critical illness at the University of Cincinnati cardiovascular and trauma surgical intensive care units. These rotations will expose the fellow to a broad mix of patients as they obtain knowledge from these world class institutions. Cincinnati Children’s hosts one of the largest ECMO programs in the country.
The fellow will be eligible and encouraged to obtain board certification by the American Board of Surgery in Surgical Critical Care through the surgical critical care certifying examination. The fellow will review the curriculum along with core faculty presented by the Society of Critical Care Medicine for Surgical Critical Care throughout the year and will participate in lecture series, morbidity and mortality conferences, performance improvement and quality conferences and journal club. The fellow will be involved in the teaching of fellow colleagues in other subspecialties in the intensive care units and rotating residents throughout the services. The fellow will be involved in a research project to be completed during the year of training.
The fellowship is offered to applicants who have completed their general surgery training and pursue further training in perioperative care of the critically ill patients. The fellow will learn from Intensivists on every rotation and will be guided by intensivists and surgeons throughout all their training. The fellows will obtain experience in the management of complex pediatric and adult surgical patients, including the management of complex respiratory, cardiovascular, neonatal, infectious disease, anesthesia, complex airway, neurological, endocrine, trauma, fluid management, nutrition and electrolyte conditions as well as mechanical ventilation, ECMO, and a variety of bedside and operating room procedures. The fellows will have clinical expertise which will provide them with excellent opportunities to obtain a job in highly recognized academic centers after completing their training.
Upon completion of the program, the fellow will be expected to demonstrate competence in
- Evaluation of surgical critical care patients including appropriate and cost-effective use of diagnostic examinations
- Definition of an optimal therapeutic plan and choice and implementation of appropriate therapy
- Knowledge of current surgical literature and appropriate application to patient care
- A well-rounded approach to patients and family members
- Establish good interpersonal relationships with medical professional colleagues
- Ethical, cost-effective, socio-economic and medical-legal issues
- Facility in written manuscripts and oral presentations
Program Certifications
ACGME accredited
Teaching Staff
Pediatric Surgery – Alexander Bondoc, MD Rebeccah Brown, MD, FACS, FAAP Roshni Dasgupta, MD, MPH Richard A. Falcone Jr., MD, MPH, MMM Jason S. Frischer, MD Laura Galganski, MD, MAS Victor F. Garcia, MD, FACS, FAAP Aaron P. Garrison, MD Michael A. Helmrath, MD Meera Kotagal, MD, MPH Foong-Yen Lim, MD Jose L. Peiro, MD, PhD Todd A. Ponsky, MD Nelson G. Rosen, MD Beth Rymeski, DO Greg M. Tiao, MD Paul W. Wales, MD, MSc Ashley Walther, MD, FACS and Daniel von Allmen, MD.
The training program director, Juan Pablo Gurria, MD, MSc, will coordinate all aspects of the fellowship training program. The surgical faculty will supervise the fellow on all operative cases as well as on inpatient and outpatient care.
Facilities
All training is conducted at Cincinnati Children’s and the University of Cincinnati Medical Center.
Cincinnati Children's is a private medical center providing 580 inpatient beds. The hospital is one of the largest children’s care facilities in the United States in several categories: number of beds, number of emergency room visits, and number of operative procedures.
University of Cincinnati Medical Center has approximately 100 adult critical care beds, distributed through the surgical, medical, neuroscience, and cardiovascular intensive care units. The SICU consists of 34 adult beds with 150-170 monthly admissions from all surgical specialties, including trauma, general surgery, transplantation, surgical oncology, vascular surgery, urology, ENT, thoracic surgery, obstetrics/gynecology and ENT.
Educational Program – Basic Curriculum
During the training period, this individual will be expected to participate in the pediatric trauma, pediatric intensive care, neonatal intensive care and surgical adult critical care educational programs, outpatient and inpatient care, routine and complex surgical procedures. The trainee will also be involved in clinical research projects. The trainee may also participate in shared general pediatric surgery clinical and educational experiences with our current pediatric surgery trainees when deemed to be beneficial.
The goal of this fellowship position is to enable the trainee to gain expertise in the diagnosis, medical and operative management of a wide spectrum of surgical critical care. This experience will first and foremost expand the pool of specialists who will be able to care for these patients. In addition, this experience will permit the practitioner to enhance their expertise in the treatment of pediatric trauma.
Rotations:
- Pediatric Surgery
- NICU
- PICU
- CVICU
- Anesthesia/Airway
- SICU (at University of Cincinnati)
The ultimate responsibility for care of the patients is the attending surgeon. No patient is admitted to the hospital, undergoes a procedure, or procures a consultation without the attending surgeon being made fully aware and assuming full responsibility. The fellows will make bedside rounds with the attendings on a daily basis to go over patient progress, make management decisions, and raise any concerns. Attendings will be notified promptly of all new pediatric trauma admissions and make bedside rounds on these patients with the trauma fellow within 24 hours of admission. There will be extensive and frequent communication both at the bedside and in the department regarding patient management decisions. Trauma fellows will also respond to all daytime and on-call trauma stats and communicate their findings and management decisions directly to the trauma attending.
Daily
- Bedside rounds
Weekly
- UC Surgical Grand Rounds
- Pediatric Surgery Grand Rounds
- Pediatric Surgery/Radiology Conference
- Pediatric Surgery Morbidity and Mortality Conference
- Textbook Chapter Review
- PICU weekly educational meeting
- NICU weekly educational meeting
- SICU weekly educational meeting
Monthly
- Trauma Case Review
- Trauma Morbidity and Mortality Conference
- Trauma PI Committee
Fellows are evaluated every quarter by the program director, and a summary evaluation is conducted at the conclusion of the fellowship. In addition, the subspecialty residents are expected to provide formal evaluations of the individual faculty members, the program of learning, and the program resources on an annual basis. This information is collated and presented to the faculty in an anonymous fashion.
3333 Burnet Avenue, Cincinnati, Ohio 45229-3026
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