Surgical Critical Care Fellowship

Training Critical Care Surgeons at Carilion Clinic - Virginia Tech Carilion

Program Overview

The goal of the Carilion Clinic - Virginia Tech Carlion Surgical Critical Care Fellowship is to provide an environment in which the fellow will learn to demonstrate appropriate, evidenced based, direct care to patients with critical illness and injury, including life threatening trauma and multi-system organ failure.

Clinical Experience

Carilion Clinic is a not-for-profit institution providing care to all, located in southwest Virginia. Fellows will be located at Carilion's flagship hospital, Carilion Roanoke Memorial Hospital (CRMH). CRMH is licensed for 765 inpatient beds with 60 NICU beds, 36 bassinets and staffs 717 inpatient beds. It is also the only Level 1 Trauma center in western Virginia.  CRMH also provides tertiary care services of cardiac surgery, high-risk obstetrics, neonatal intensive care, cancer care, and pediatric and adult critical care. CRMH services the Roanoke Valley’s population of about 250,000 and has a referral area of over one million people.

Fellowship Rotations

Surgical ICU and NeuroTrauma ICU (8 months)

• A combination of trauma patients and critically ill surgical patients from multiple services (general surgery, neurosurgery, orthopedics, obstetrics and gynecology, otolaryngology, trauma). This rotation offers a macro view of critical care experience, providing the resident with a perspective of combined services needed for the SICU professional physician to master.

Medical Intensive Care Unit - Bedside Critical Care Ultrasonography (1 month)

• Carilion Clinic offers expertise in the use of ultrasound in the ICU. We have a four day course teaching the application and skill of ultrasound in critically ill patients.

Electives

• Critical Care Transport - Fellow will learn how to safely and competently manage critical care patients during transport, including ventilation, intraaortic balloon pump, hemodynamic monitoring and medication, and complex airway management. They will learn how to manage groups of patients in austere medical environments remote from the hospital. Included within this rotation are opportunities for disaster training and planning including scene triage of patients in multiple casualty incidents.
• Anesthesia-Emergency Airway - Fellow will have the opportunity to learn airway management, intraoperative resuscitation and hemodynamics. Carilion Clinic does not have an anesthesia residency, so the fellow will have the unique opportunity to receive direct one-on-one teaching from an anesthesia attending.
• Palliative Care Medicine - This specialty is completely integrated into the intensive care units and CRMH has a six bed Palliative Care Unit of its own. Palliative Medicine offers expertise in pain medicine, symptom control, family and patient support for life changing events, and assistance with end of life decision making.
• Interventional Radiology - Fellow will learn techniques including IVC filter placement, abdominal and thoracic abscess drainage and percutaneous intravascular hemorrhage control techniques.

Vacation (1 month)

Clinical Skills/Competencies

Overall, the breadth and depth of experience Carilion Clinic-Virginia Tech Carilion offers in surgical critical care provides a high quality and unique educational opportunity for the critical care surgery resident. The rotations of Critical Care Transport, Interventional Techniques, Palliative Medicine and Ultrasound in the ICU add a dimension to Surgical Critical Care training that is not offered by many other programs.

Over the course of the fellowship, the following knowledge and competencies will be obtained:

• Resuscitation skills
• Emergency airway management
• Laryngoscopy and intubation techniques
• Ventilator management skills
• The performance of bedside procedures, specifically central venous and arterial catherization, intubations, chest tubes, pulmonary artery catheters and fiber optic laryngotracheobronchoscopy
• Proper management for patients requiring large volume fluid and blood product resuscitation
• Proper assessment and management of patients with intracranial hypertension
• Application of clinical criteria of brain death and basic principles of support for potential organ donors
• Perform urgent consultation in the emergency department, post-anesthesia recovery unit, medical-surgical wards and ICUs
• Identify, evaluate and prioritize current ICU patient care needs by participating in daily rounds on critically ill patients

Research

Fellows will be expected to participate in research over the course of the year. Fellows are encouraged to develop an original project or collaborate with faculty on established projects in the department. Access is available to Carilion Clinic's Trauma Registry and to the National Trauma Database.

How to Apply

Candidates must submit the application and supporting materials, including a C.V., one letter of recommendation from the Chairman of the Department of Surgery, and one letter of recommendation from other faculty in the Department of Surgery, to the Division of Surgical Critical Care.

Download the fellowship application

Contact Us

Mark Hamill, M.D.
Program Director, Surgical Critical Care Fellowship