Fellowship Program Structure

UT Southwestern Medical Center and Parkland Memorial Hospital have a long history in the field of trauma and surgical critical care and offer a strong ACGME-accredited program designed to successfully prepare candidates to sit for the Surgical Critical Care Examination offered by the American Board of Surgery (ABS). Since the program started in 1994, we have a 100 percent first-time pass rate for this exam.

Parkland is an ACS verified Level 1 Trauma Center and had just under 8,000 traumas last year with 3,200 admissions. Our SICU service provides critical care for the trauma, emergency general, elective general, ENT, OMFS, Ob/Gyn, and orthopaedic surgery services (about 1,200 patients per year).

Track 1

An ACGME-approved one year experience consisting of the following:

• Six months in one of three SICUs (Parkland Memorial Hospital, Clements University Hospital, THR Presbyterian Hospital). The fellow will be primarily responsible for a spectrum of critically ill surgical patients. Service lines within the SICUs include transplant, vascular, surgical oncology, ENT, plastics, thoracic, urology, ob/gyn, trauma and EGS. All patient management will occur under the direct supervision of an attending physician.
• Two months Parkland Memorial Hospital trauma/EGS service. The fellow will formally rotate on one of the Parkland Memorial Hospital trauma/EGS services where he/she will function at the level of chief resident. All patient management will occur under the direct supervision of an attending physician. The fellow will actively take part in trauma resuscitations and the operative management of traumatic and emergent general surgical conditions. These busy services each average 70 cases per month.
• Three months critical care electives. The fellow will rotate on burns, CV-ICU and anesthesia. Alternative electives are available upon request.

Track 2

This is a two-year AAST ACS approved fellowship track. The first year will be identical to track 1. At the completion of the first year of training, the fellow will transition to the operative ACS fellowship. They will spend 7 months on both our Parkland trauma/EGS service and ACES service at Clement's Hospital. Here, they will function as junior faculty under the guidance of select faculty. Institutional privileges will be granted for general surgery and trauma cases where the fellow will have complete autonomy. A senior faculty member will function as a backup should technical or judgmental assistance be required. The fellow will also rotate on cardiothoracic, transplant, vascular and endocrine to gain additional exposure to head/neck, chest and vascular procedures. During the elective months, the fellow will be supervised by an attending physician from the respective sub-specialty service. A prerequisite for matching into this track is that the fellow be eligible for Texas licensure. The fellow will also have full access to the AAST ACS fellowship curriculum and attend weekly lectures. They will graduate with a AAST ACS fellowship certificate.

Track 3

This is an ACGME approved 1-year position that encompasses the management of burn patients, surgical critical care and reconstructive surgery. After successful completion of the program, the fellow will meet the requirements to sit for the ABS Surgical Critical Care boards and will receive a burn certificate. Requirements for this year include 6 months on the Burn ICU service, 4 months of SICU, and 2 months of electives (CV-ICU, Anesthesia). (This track is also listed separately under burn fellowships on the American Burn Association Website.

Other potential electives include MICU, CCU, PICU, Neurosurgery NCC, Ortho, Pulmonary, CTICU, and Transplant Surgery.

The second year fellow advances to a Clinical Instructor position and is assigned institutional privileges. The fellow will function at the level of a junior attending with complete autonomy for a defined period of 12 months. On the assigned rotations (within the Division of Burn, Trauma, Acute and Critical Care Surgery) the Clinical Instructor takes on the role of primary surgeon for the service and is paired with a more senior faculty member who will provide mentorship and function as a source of around-the-clock backup should technical or judgmental assistance be desired on the part of the Clinical Instructor. On the other rotations, the Clinical Instructor functions as a fellow (trainee).

Other electives are potentially available and will be arranged to address other desired areas of focus.

We have excellent faculty who are dedicated to teaching future surgeons and encourage any resident who is considering a fellowship in Surgical Critical Care to apply to our Program.