The goal of the University of Louisville Surgical Critical Care & Acute Care Surgery Fellowship Program is to produce a well-rounded surgeon with clinical competence in the care of critically ill patients. At the completion of the fellowship, the trainee will have factual knowledge and technical skills with respect to preoperative, evaluation, operative management, and postoperative care of patients with critical illness.

Training will include techniques for both life-saving and diagnostic procedures, not only their performance, but the correct interpretation within the scope of the critical illness. Trainees will be competent in the interpretation of radiographic studies to include head, chest and abdominal and pelvic CT scan, abdominal ultrasound , and vascular angiographic studies. Fellows will be knowledgeable in the application of monitoring techniques applicable to surgical critical care and be aware of the indications and contra-indications to these approaches.

It is anticipated that upon completion of the fellowship in surgical critical care, that fellows will be prepared to play an active role in the socioeconomic, political climate, and unit administration that has impact on the care that they are able to provide to patients. They will also develop the presentation skills that will allow them to deliver an effective medical presentation and effective communication of complex diseases processes among other healthcare providers.

Medical Knowledge Goals

This includes knowledge of the anatomy, physiology, biochemistry, pharmacological, and clinical management of diseases that pertain to critical illness. The trainee will have a thorough understanding of the diagnosis, medical and surgical treatment of patients with critical illness.

Didactic/Teaching Objectives

The objective of the Surgical Critical Care Program is to provide additional experience for trainees whose career plan includes a major focus in critical care. The objective is for the fellow to obtain in-depth knowledge in the following aspects of critical care:

Cardio-pulmonary resuscitation

Physiology, pathophysiology, diagnosis and treatment of cardiovascular, respiratory, gastrointestinal, genitourinary, neurological, endocrine/metabolic, musculoskeletal, immune and infectious disorders

Metabolic, nutritional, and endocrine effects of critical care illness

Hematological and coagulation disorders

Critical obstetrical and gynecological disorders

Trauma, thermal, and electrical burns

Monitoring and invasive instrumentation

Critical pediatric disorders

Pharmacological kinetics / dynamics of drug metabolism and excretion in the ICU

Ethical and legal aspects of critical care

Principles and methods of ICU administration

Biostatisics and experimental design

Patient Care Goals

Competence will be attained in the evaluation and treatment of patients with critical illness. This includes knowledge regarding the molecular basis of such disease. The trainee will become familiar with the indications of adjuvant therapy and with the complications associated with these treatments. Understanding of the role of both medical therapy and surgery in the treatment of patients with critical illness will be a major goal of the fellowship. This includes proficiency in procedures performed in patients with critical illness to include invasive hemodynamic monitoring, management of the airway, bronchoscopy, GI endoscopy, ventilator management, and other life saving procedures.