University of California, School of Medicine, Dept of Surgery, at Program Description A. PROGRAM DEMOGRAPHICS Name of Host Institution Program Specialty/Subspecialty Program Mailing Address Program Physical Location University of California, School of Medicine, Department of Surgery Trauma Surgery Department of Surgery 1001 Potrero Ave, Ward 3A, CA 94110 1001 Potrero Ave, CA 94110 Program Phone Number (415) 206-4622/(415) 206-4627 Program Fax Number (415) 206-5484 Program E-mail Program Director Alternate Program Contact rmackersie@sfghsurg.ucsf.edu acampbell@sfghsurg.ucsf.edu Robert Mackersie, M.D. Andre Campbell, M.D. B. INTRODUCTION 1. History: is one of the oldest Trauma Centers in the United States. The Trauma Center at was dedicated on October 15, 1972. The hospital is the only Level I Trauma
Center serving the City and County of serving a community of 1.5 million people. Since the inception of the Trauma Center there has been a tradition of training surgeons to care for injured patients. Many of the surgeons who trained at have gone on to be world-renowned traumatologists. During last three decades many surgeons have come to UCSF and obtained fellowship training at honing their skills and learning about state of the art trauma care. In 1999, University of California, received approval from the Accreditation Council for Graduate Medical Education (ACGME) /Residency Review in Surgery (RRC) for a fully accredited Surgical Critical Care Fellowship. Since the approved of the fellowship five years ago, we have two individuals who desired further training in the Trauma Surgery and they opted to spend a second year further developing their skills in Trauma Surgery. The first year of training is a Surgical Critical Care Fellowship and the second year of training is a. 2. Duration: The is currently one-year duration. It typically begins on July 1 and end on June 30 of the academic year. 3. Prerequisite Training/Selection Criteria: The applicants who are accepted to the are typically board eligible surgeons in the United States who have completed the Surgical Critical Care Fellowship. All the fellows have completed five formal years of surgical training prior to coming to participate in our fellowship. We also accept applicants who have equivalent board eligibility from another country with appropriate supporting documentation from the applicant and their medical school. 4. Goals and Objectives for Training: The at is devoted exclusively to educational activities that are focused on the care of critically injured trauma patients and to the administration of trauma services and critical care units. The goal is to train surgeons who have advanced skills in caring for critically injured patients. 2
The advanced level of skill acquired during this fellowship will allow the fellow to manage the following types of difficult problems 1) surgical or non surgical injured patients; 2) pre-operative and postoperative care injured patients who required critical care. 3) Patients of all age groups who have comorbidities involving heart, respiratory, renal and other metabolic problems. In addition this advanced level of skill will allow the fellow to master the use of advanced technology and instrumentation to monitor the physiological status of trauma patients. The fellow will be expected to develop skills in teaching and research related to trauma/critical care patients. We expect the fellow to produce at least one peer reviewed publication during the one-year fellowship at. Ethical, economic and legal issues that pertain to trauma care will be discussed. By the end of the training we expect that the fellow will be able to direct a trauma service. This includes the ability to appoint, train, and supervise specialized personnel. The trainee will be expected to establish policies and procedures for management of injures patients. The fellow will develop the skills necessary to write privileges for surgeons who will work with them on a hospital medical staff. The fellow will be trained to teach the special body of knowledge required for comprehensive management of trauma patients. The fellow will develop skills to perform research in the areas of prevention, acute care, and rehabilitation. During the course of the fellowship they will learn how to establish a trauma registry and understand the entire process of peer review and performance improvement. 5. Program certifications: is a Level I Trauma Center certified by the American College of Surgeons. As a certified Level 1 Trauma center in addition to providing state of the art trauma care, there are numerous other research programs that are associated with the Department of Surgery at. is a fully integrated part of the University of California, San Francisco School of Medicine Network. All the faculty who teach at have full academic appointment in The Department of Surgery. The Department of Surgery at UCSF has a fully accredited Surgery Residency program. Surgical residents at the UCSF 3
typically spend five years doing clinical training and one or two years engaged in research. In addition, state of the art research on basic science problems as well as clinical problems is explored on a daily basis in the Department of Surgery at. C. RESOURCES Teaching Staff: Faculty members: Site: Supervisory responsibilities: Robert Mackersie, M.D. Full-faculty involved in clinical and didactic teaching of surgical critical care. Directs Trauma Video-tape conference (resuscitative critical care). Director of Trauma SFGH. Involved with clinical research and curriculum development. Andre Campbell, M.D. Arthur Hill, M.D. Jan Horn, M.D. Mary Margaret Knudson, M.D. Stanley Rogers, M.D. William Schecter, M.D. Director of Surgical Critical Care at SFGH and Co-director of the ICU. Involved daily in ICU and trauma training. Director of Surgical Critical Care Fellowship. Involved with curriculum development, clinical and didactic teaching. Full-time faculty involved in clinical and didactic teaching. Involved with organization of the conference curriculum. Full-time faculty involved in the clinical and didactic teaching. Involved in clinical and basic science research. Full-time faculty involved in the clinical and didactic teaching. Involved in clinical and basic science research. Full-time faculty involved in the clinical and didactic teaching. Involved in clinical and basic science research. Full-time faculty involved in clinical and didactic teaching. 4
2. Facilities: GENERAL INFORMATION 1. Parent Institution: Name: Address: 1001 Potrero Avenue, Ward 3A, California 941110 Length of Rotation in Months: 12 months of rotations at, 1-month on Neurosurgery and 1 month on Interventional Radiology is include: Medical School Affiliation, if any: University of California, D. EDUCATIONAL PROGRAM - BASIC CURRICULUM 1. Clinical and Research Components: The Department of Surgery at has a busy clinical and basic science program. The department has a state of the art research lab at dedicated to exploring the basic science aspects of the stress response. This lab is the recipient of millions of dollars of funding from the National Institutes of Health. San Francisco is also the location of Injury Center (SFIC) that was established in 1989. The SFIC is one of eleven Injury Control Research Centers nationwide funded by the National Center for Injury Control and Prevention at the Centers for Disease Control. The core mission of the injury center is to focus on the reduction of injuries through the development of prevention strategies working with community agencies and national organizations to help train the next generation of researchers and affect policy change. The fellow can participate in clinical research projects that are part of the injury center acute care project section. In addition, there are many clinical research projects that are in progress in the ICU conducted by number of investigators. The fellow can work with any of these faculty members on trauma related projects. We will require that the fellow have one peer-reviewed publication during the year. 2. Participant s supervisory and patient responsibilities Participant s supervisory patient care responsibility: the fellow will be responsible for patients care under the supervision of our surgical faculty. 5
All of the surgical faculty members are fully trained board certified surgeons who have extensive experience in caring for injured patients. The faculty who supervise the fellows in the ICU are fully trained in Critical Care Medicine. 3. Procedural Requirements: The Trauma Fellow will participate in operations under the direct supervision of a surgeon who is board certified in general surgery. The fellow will also participate in emergency general surgery under the supervision of the faculty. The fellow will also participate in ICU procedures when they occur during the course of the year. These procedure are supervised by the ICU attending. 4. Didactic Requirements Curriculum Overview: The program will provide for opportunities for the fellow to learn about the following areas of trauma care. 1. Coordination, evaluation and supervision of a trauma system. Including prehospital care and transport. The fellow will learn about creating and maintaining a trauma registry. The quality improvement process will be introduced during the course of the year. 2. Evaluation, resuscitation, and surgical and increasing nonsurgical management of trauma patients. The role of nonoperative therapy of solid organ injuries will be taught. 3. Physiology, pathophysiology, diagnosis, and therapy of disorders of the cardiovascular, respiratory, gastrointestinal, genitourinary, neurologic, endocrine, musculoskeletal, and the immune systems. 4. Metabolic, nutritional, and endocrine affects of critical illness, including shock, sepsis, and multiple organ failure. 5. Hematolgic,, and coagulation disorders. 6. Thermal, electrical and radiation injuries. 7. Monitoring and medical instrumentation. 8. Pharmacokinetics and dynamics of drug metabolism and excretion. 9. Ethical and legal aspects of trauma care. 10. Biostatics and design of experiments. 6
E. EVALUATION The trainee will be evaluated regularly by written reports covering the development of knowledge skills, relationship with other colleagues and staffs, administration and teaching abilities. At the University of California, School of Medicine all surgical trainees are evaluated electronically. This information will be give to the fellow by the program director to help them improve their performance. There will be regular meetings between the program director and the fellow. This will happen at least twice a year but more if required. The fellow will submit evaluation of the program and faculty. The Program Director will be work closely with the program director of the parent general surgery program to ensure that the program works smoothly. If problems occur they will be discussed with the director of the parent program. Submitted by Andre R. Campbell, MD, Date 7