Surgical Clinical Care Fellowship - Rotations
As a fellow on the Trauma service at the Shock Trauma Center you are leading a team of residents (surgical and EM). During a busy and exciting month you are responsible for admitting all trauma patients when on-call, running trauma resuscitations, managing the trauma bays and overseeing your team in the care of all trauma patients on your service.
As a first year fellow you will be an active member of the surgical team on the Acute Care Emergency Surgery Service. You will be rounding with the surgical team, consulting on medically complex and critically ill patients, as well as operatively assisting in cases including things like appendectomy, cholecystectomy, bowel ischemia, abdominal compartment syndrome, as well as a myriad of other pathologies. These two months are the bread and butter (?Foundation) of your first year.
Rotation on the cardiac surgery service will involve collaborative care of post operative patients in the CSICU as well as a substantial amount of time in the operating room participating in a wide variety of cases. Aortic dissections, coronary bypass grafting, and valve replacements are among the basics of what you’ll see this month. During this month you will also have the opportunity to observe and learn from cardiac anesthesia, perfusionists, and observe intraoperative TEE.
Shock Trauma has a team dedicated to the care of soft tissue infections. While rotating on this service you will have the opportunity to learn about extensive necrotizing wound infections, participate in operative debridement, provide wound care for complex and often large wounds as well as participate in reconstructive efforts for these wounds.
A novel unit dedicated to the care of critically ill patients who need tertiary care will provide an experience to manage incredibly sick patients. During this rotation you will be working directly with the attending to provide care to a variety of critically ill patients from aortic dissections, ruptured AAA, acute fulminant liver failure, massive GIB, acute ischemic or hemorrhagic stroke as well as many other diagnoses. This rotation offers an exceptional opportunity to perform procedures and broaden the depth of your critical care knowledge.
On your non-clinical CCRU days, you will have an opportunity to perform TTE/ TEE with the critical care ultrasound program.
While on your month in the Lung Rescue Unit you will be learning and managing VV ECMO at one of the busiest ECMO centers in the country. You will be caring for patients with ARDS of all etiologies including trauma, COVID, pneumonia, end stage lung disease, pancreatitis, as well as a host of others. The indications, contraindications, and general course of ECMO dependent ARDS will become well understood. You will learn the nuance of ECMO management as well as learn to anticipate and treat common complications associated with ECMO.
Cardiac Surgery ICU
Your month in the cardiac surgery ICU provides you with the chance to provide post operative critical care to patients with complex medical problems and sick hearts. During this month you will manage mechanical support devices (VA ECMO, VADs, Impella) as well as care for patients who have had high risk, complicated cardiac interventions, severe cardiogenic shock and pulmonary hypertension. Your knowledge of cardiac physiology will deepen and you will become comfortable with the management of inotropic support.
Multitrauma ICU provides you with the bread and butter of trauma critical care. An ICU dedicated to only the sickest trauma patients, you will have an abundance of opportunity to learn from teams who have committed their time and careers to victims of trauma.
As the neurotrauma center for the state of Maryland, the Neuro Trauma Critical Care Unit cares for those patients with traumatic brain and spinal cord injuries. You will learn current evidence based practices and work with both neurointensivist and trauma neurosurgeons while providing care for traumatic brain injuries and spinal cord injuries.
A busy SICU caring for a wide variety of patients including severe pancreatitis, open abdomens, head and neck cancer resections, vascular emergencies, and you will be functioning in a traditional fellow role, overseeing a team of residents and advanced practice providers.
Working directly with a trained ultrasonographer you will learn how to complete a full echocardiographic examination, interpret the data you collect, and make recommendations on fluid status and fluid responsiveness. By the end of your rotation you will have a strong foundation of TTE.