Surgical Critical Care Fellowship

The Surgical Critical Care Fellowship program at Yale is designed to train leaders in academic surgical critical care and trauma through a rigorous clinical and educational experience. Two surgeons are accepted annually into this RRC-approved one-year program, and they are immersed into the management of critically ill and injured patients. The program also provides the opportunity for the fellow to gain unique expertise in specialty areas through elective rotations and research.

Qualified applicants must meet the following prerequisites:

• Completion of an approved general surgery residency with Board eligibility or certification by the American Board of Surgery, or
• Completion of three years of general surgery residency with a designated categorical position, and
• Established ability as a teacher of medical students and residents.

Description
Critical Care Fellows are involved in the education of students and residents who are rotating on the Surgical Critical Care Service, and to provide daily management of critically ill patients. Residents come from the Departments of Surgery and Anesthesia. In addition, fellows from the Section of Pulmonary Medicine and senior medical students rotate on the service. The service manages approximately 2200 patients a year, including patients admitted to the 14-bed SICU, 14-bed NICU, and the 6-bed Step-Down unit. The Critical Care Fellow is expected to provide regular didactic lectures to the ICU team, and attend a weekly Critical Care Conference Lecture Series. Daily ICU rounds are held with attending physicians from the Departments of Surgery and Anesthesia by faculty members who are Board-certified or Board-eligible in critical care medicine. Clinical research activities are an important component of the fellowship. The Fellow attend a national annual meeting, and participate in the Advanced Trauma Operative Management (ATOM) course.

Objectives

1. The completion of an accredited surgical residency training program qualifies the surgeon to manage critically ill surgical patients. Therefore, the surgical critical care program must enable the resident to acquire an advanced body of knowledge and level of skill in the management of critically ill surgical patients in order to assume the leadership role in teaching and in research in surgical critical care. This advanced body of knowledge and level of skill must include the mastery of: (1) the use of advanced technology and instrumentation to monitor the physiologic status of children or adults; and (2) organizational and administrative aspects of a critical care unit; and (3) ethical, economic, and legal issues as they pertain to critical care.
2. 2. In addition, individuals completing a training program in surgical critical care will be expected to be able to:
   • Teach the specialty of surgical critical care.
   • Undertake investigations into the various areas of surgical critical care, such as new instrumentation, identification of important physiologic parameters, evaluation of pharmacologic agents in critically ill patients, or health outcomes and/or health policy issues related to surgical critical care.
   • Administer a surgical critical care unit and appoint, train, and supervise specialized personnel, establish policy and procedures for the unit, and coordinate the activities of the unit with other administrative units within the hospital.

Clinical Research Projects
The Surgical Critical Care Program has an active research agenda with a variety of clinical, basic science and outcomes measurement oriented projects. Examples of these ongoing projects are:

• Acidosis in the ICU, including co-measured ions
• Hemoglobin-based oxygen carrier molecules in resuscitation
• Airway Pressure Release Ventilation for the management of lung injury
• Nosocomial infection and transmission in the ICU
• Management and prevention strategies for ventilator-associated pneumonia in the ICU
• Outcomes measurement research in critical care (performance improvement)

Faculty
Kimberly A. Davis, MD, Associate Professor of Surgery and Chief
Gerard A. Betro, MD, Instructor of Surgery
Lewis J. Kaplan, MD, Associate Professor of Surgery
Stephen Luczycki, MD, Assistant Professor of Anesthesiology
Felix Y. Lui, MD, Assistant Professor of Surgery
Stanley Rosenbaum, MD, Professor of Anesthesiology
John Sather, MD, Assistant Professor of Surgery
Kevin M. Schuster, MD, Assistant Professor of Surgery

Application Information
Lewis J. Kaplan, MD, FACS, FCCM, FCCP
Associate Professor of Surgery
Director Surgical Critical Care Program
Yale University School of Medicine
330 Cedar Street, BB310
New Haven, CT 06520-8062

Phone: (203) 785-2572
Fax: (203) 785-3950
E-Mail: lewis.kaplan@yale.edu