Surgical Critical Care Fellowship Curriculum

Fellows participate in all phases of surgical critical care. This program focuses heavily on a clinical experience within an approved general surgery residency program. The program directors oversee fellows' academic, clinical, and research experiences.

Fellows participate in our didactic curriculum, which consists of an online curriculum, didactic conferences, simulation center sessions, assigned readings, ultrasound curriculum, and critical care journal club. Fellows will complete the assigned online curriculum according to schedule and attend weekly Core Conference. Fellows will also attend additional didactic conferences, such as the Interdisciplinary Critical Care Conferences, ultrasound conferences, and simulation center sessions. Fellows are excused from clinical duties during the didactic conferences and simulation center sessions. Journal club presentations include a structured critical appraisal of the selected literature.

The fellow is expected to attend and participate in the following:

• Online curriculum, assigned weekly
• Core Critical Care Conference, weekly
• Ultrasound conference, weekly
• Journal Club, quarterly
• Interdisciplinary Critical Care Conference: Intro to ICU (weekly, Aug)
• Interdisciplinary Critical Care Conference (monthly, Sept-June)
• Multidisciplinary Workshops (e.g., difficult airway, ultrasound)
• Department of Surgery Grand Rounds and its workshops

Ben Taub Hospital is an urban, ACS verified level 1 trauma center and a part of Harris Health System, which serves residents of Harris County of age >16. The trauma center admits approximately 3,000 patients per year, with 30% penetrating injury and 70% blunt, while Ben Taub also serves as a stroke center and a STEMI center, and provides advanced surgical care within a variety of specialties.

The TSICU team is led by a board-certified Surgical Critical Care specialist, and all TSICU attending physicians are on faculty at Baylor within the Michael E. DeBakey Department of Surgery. The team consists of the faculty, a surgical critical care fellow, PGY-1 and PGY-2 residents, as well as third and fourth-year medical students. Residents from a variety of specialties rotate through the TSICU, providing a diverse group of team members and learners. The surgical critical care fellow is expected to lead the clinical team and direct educational efforts.

The Surgical Intensive Care Unit (SICU) at Baylor-St. Luke’s Medical Center is a 12-bed intensive care unit that admits patients under 18 years of age. The majority of the patients admitted are general surgery and surgical subspecialty patients including vascular, surgical oncology, urology, orthopedics, otolaryngology, gynecology, and abdominal transplant patients. The SICU service follows all patients admitted to the SICU and acts as a co-management service using a collaborative model of care delivery. The SICU team is led by a board-certified Surgical Critical Care specialist. All SICU attending physicians are on faculty at Baylor College of Medicine.

The team consists of a board certified critical care attending, a surgical critical care fellow, a PGY-1 day general surgery resident, a night general surgery resident, a day nurse practitioner and a night nurse practitioner (or physician assistants). The team may also include third and forth year medical students. The surgical critical care fellow is expected to lead the daily clinical activities of the team, including bedside rounds, coordinating with the primary surgical services, and performing bedside procedures.

The Thoracic Intensive Care Unit (TICU) at Baylor St. Luke’s Medical Center is a 12-bed intensive care unit that admits patients > 18 years of age who are in the perioperative phase of thoracic surgery. The majority of the patients admitted are thoracic surgery patients, including oncologic, vascular, and general thoracic surgery. The TICU service follows all patients admitted to the TICU and acts as a co-management service using a collaborative model of care delivery. The TICU team is led by a board-certified Surgical Critical Care specialist. All TICU attending physicians are on faculty at Baylor College of Medicine.

The team consists of a board-certified critical care attending, a surgical critical care fellow, and a PGY-1 day general surgery resident.. Fellows are educated on the core competencies through exposure at daily TICU rounds, weekly lectures, Grand Rounds and weekly Morbidity and Mortality conference and Multidisciplinary Case Conference. Additional exposure to patients with ventricular assist devices and extra-corporeal life support may be obtained.

The Pediatric Surgical Intensive Care Unit (SICU) at Texas Children’s Hospital a 12-bed, cohorted unit that serves as the primary site for the pre and postoperative management of the most complex, critically ill pediatric surgical patients. The primary patient population includes but is not limited to: liver and kidney transplantation, neuromuscular spine reconstructions, complex poly trauma, complex general and thoracic procedures, complex surgical oncologic resections, complex head and neck procedures including laryngotracheal reconstruction and maxillofacial tumor resections, and complex free-flap reconstructions. The SICU is located directly above Legacy Tower’s six technologically-advanced operating rooms for neurosurgery, orthopedics, plastic surgery, transplant and pediatric surgery – one with intraoperative MRI. Additionally, there is an on floor simulation suite with scheduled weekly trauma simulations.

The SICU team led by an intensivist, and the team consists of front line providers and supervisory critical care fellows. The adult SCC fellow will serve as the front line provider for up to six patients and will also have the opportunity to participate in the care of surgical patients housed in the other cohorts as well as patients on ECMO. The pediatric focus SCC fellow will initially serve as a front line provider and then transition to the supervisory fellow role over the course of their ICU experience.

Legacy Tower’s 84 PICU beds are divided into several units including: surgical, neurologic, advanced respiratory, general intensive care, oncology/bone marrow transplant, and transitional. The transitional unit serves to meet the needs of complex, technology dependent children. Legacy Tower also serves as the home for Texas Children’s Heart Center® and includes an additional 48 cardiac intensive care beds divided into neonatal, heart failure, and congenital heart surgery cohorts as well as four cardiac catheterization labs including integrated MRI scanner and four cardiovascular operating rooms.