FAQs

Post-graduate training, including that in surgical critical care, is frequently referred to as a "fellowship". As this training program is accredited by the Residency Review Committee (RRC) of the ACGME, it is officially termed a "residency". For all intents and purposes, the two terms are synonymous in this setting and are used interchangeably.

No. The ACGME requires that each applicant has either completed an ACGME-accredited residency program in general surgery, neurosurgery, urology, or obstetrics/gynecology OR completed at least three (3) years of clinical training with a categorical position to return to in their respective specialty upon completing the surgical critical care residency program.

Yes. In fact, a number of board-certified general surgeons have completed the residency program in recent years to either gain further knowledge and experience to improve their patient care or as a means to redirect their surgical career.

The ACGME requires that no more than 25% of the residency time be devoted to direct operative care. We consider this residency to be "non-operative" in that the surgical critical care residents do not have operative responsibilities outside of the critical care unit. The residency is oriented to promote the development of advanced skills in the diagnosis and management of the critically ill, using the latest technology, instrumentation, and medications. This advanced knowledge and expertise in clinical patient care, unit administration, and research activity comes at the price of not operating for at least eleven months of the residency. The residents do perform bedside tracheostomies and endoscopic procedures on a regular basis as part of their routine patient care. Occasionally, they may assist the general surgery faculty or residents with emergent bedside abdominal decompression in the critical care unit. The residents may elect to spend one of their two elective months rotating on either the Trauma Team or Burn Service where they would participate in scheduled operative procedures.

The call is generally five nights per month and shared with general surgery and emergency medicine residents. Each fellow has at least one day off each week and one to two weekends off each month without clinical responsibilities. There is no "at-home call" at any time. The ACGME 80-hour per week resident duty hours requirement is strictly followed. While on call, a designated call room is available as are a resident's lounge and physician's dining room.

The ancillary support services at ORMC are excellent. The surgical critical care residents are not required to start peripheral intravenous lines, draw blood, transport patients, or perform other roles or procedures that could be construed as being "non-educational". · These support services include: In-house surgical / trauma attending faculty 24/7; dedicated Doctor of Pharmacy specializing in surgical critical care; full-time surgical critical care research coordinator; In-house attending radiologists and radiology technicians (including ultrasound, computerized tomography and magnetic resonance imaging) 24/7; experienced respiratory therapy department; bedside echocardiography 24/7; intravenous line team 24/7; Wound Management team; Nutritional Support team.

Each trainee receives a formal one-on-one evaluation quarterly from the program director in addition to informal discussions as indicated. The evaluation of the resident's performance consists of comprehensive rotation specific evaluations by the faculty and 360-degree evaluations performed by the ICU nursing and respiratory therapy staff. The resident and program director discuss the resident's progress, clinical and diagnostic skills, technical skills, didactic knowledge, problem-solving ability, judgment, and intra-personal skills as necessary. All patient care and procedures performed by the surgical critical care residents are documented online. As a result, patient and procedure lists can be viewed and printed by the program director and resident at any time to review and monitor the resident's experience and training. The results of the annual Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) exam are discussed with each resident as they become available from the Society of Critical Care Medicine. Each surgical critical care resident completes an evaluation of each critical care faculty member on a quarterly basis or following each elective rotation, which is reviewed by the program director. Issues raised are discussed with the faculty members, as necessary, on an anonymous basis.