Surgical Critical Care Fellowship

Throughout the one-year clinical fellowship, fellows spend a significant amount of time providing care for critically ill surgical and trauma patients requiring intensive medical care. As an ACS-verified level 1 trauma center, Butterworth Hospital provides services to a variety of blunt and penetrating trauma patients. The hospital and trauma center are supported by an extensive EMS system and AeroMed flight program that extends clinical capabilities throughout the region. Serving as a tertiary and quaternary referral center, fellows will be exposed to a wide array of clinical care, innovation, and research initiatives spanning a population of over nine million. Butterworth Hospital is a 620-bed hospital with the highest number of trauma admissions and emergency general surgery operations in the state of Michigan.

Numerous patient populations are cared for including orthopedic, neurosurgery, cardiovascular, otolaryngology, burn, trauma, peripheral vascular, urology, and general surgery patients. The blended intensive care unit structure provides the fellows with a unique opportunity to care for a variety of patients and to learn from a dedicated team of general and specialty surgeons. All critical care physicians are board-certified in surgical or anesthesiology critical care. Additional rotations in the cardiothoracic intensive care unit aim to give the fellow exposure to heart and lung transplant patients, ECMO, and assist device management.

The fellowship also provides each physician with significant experience in invasive procedures including central line placement, chest tube placement and intubation, bronchoscopy, percutaneous gastrostomy tube placement, and tracheostomy placement. Fellows will maintain operative skills on the busy emergency general surgery service and participate in trauma resuscitations and operative interventions.

In addition to clinical experience, the fellowship also provides experience in surgical nutrition and research. An integral part of the fellowship is experience in the areas of metabolic response to stress, shock, and multiple organ system failure. The fellow will gain experience with fluoroscopic nasojejunal tube placement and determining TPN and tube feed needs. Other rotations including echocardiography will allow the fellow to develop a basic understanding of bedside ECHO in shock and resuscitation. Advanced airway skills are also offered to enhance the fellow’s ability to manage more routine to complex airway situations. Other activities required of the fellow include contributions to quality improvement activities and clinical protocol development. Point of care ultrasound (POCUS) is well integrated into the fellowship curriculum.

Finally, each critical care fellow can serve as a resource and teacher for junior residents throughout the fellowship experience. The Surgical Intensive Care Unit (SICU) team is comprised of residents from many different specialties including general surgery, vascular surgery, neurosurgery, plastic surgery, emergency medicine, anesthesiology, and obstetrics and gynecology. The fellow will work with and lead the multidisciplinary surgical critical care team consisting of overseeing, residents, medical and nurse practitioners, and physician assistant students. The practice is also supported by excellent advanced practice providers.

Didactics

Based upon the American Board of Surgery outline, fellows will have a dedicated weekly curriculum including a question bank to prepare for the ABS Surgical Critical Care Examination. Weekly general surgery conferences including M&M are also attended. Other conferences include weekly SICU didactics, monthly ACS journal club, Trauma Performance Committee, SICU Morbidity and Mortality, as well as attendance at daily check-in. Numerous opportunities to become involved in process and quality improvement exist for those who are interested. The fellowship year provides ample opportunity for study and preparation for the critical care board exam.

• First and second Friday of the block: SICU Fellow Lecture Series
• Third Friday of the block: Acute Care Surgery Journal Club
• Fourth Friday of the block: SICU Morbidity and Mortality Conference

Research

Under the leadership of the Trauma Research Institution, fellows have access to significant research support. The scholarly activity support team also offers biostatistics consultation and poster preparation. Numerous opportunities are available for interested fellows to be actively engaged.

Applicants must complete an ACGME-accredited general surgery program and be eligible for the American Board of Surgery examination. Exceptional residents in their PGY3 year may also apply. The fellowship runs from August 1 through July 31 of the academic year. We accept all applications through the Surgical Critical Care and Acute Care Surgery Fellowship Application Service (SAFAS) with interviews conducted from June through August.

For more information on our program, contact Jennifer Bruno, program coordinator.

Corewell Health in West Michigan provides a comprehensive and very competitive benefits package for our residents, staff, and their families. In addition, our program provides educational monies to support your ongoing education. Download our salary and benefits document to learn more.