What to Expect as a Surgical Critical Care Fellow
The goal of the SCC fellowship is to obtain experience in the multidisciplinary care of critical surgical patients, and exposure to all elements that are involved in the domain of critical care knowledge and related procedures.
Spartanburg Medical Center (SMC) is a 540-bed research and teaching facility. It is the anchor hospital for Spartanburg Regional Healthcare System a not-for-profit integrated healthcare delivery system with six hospital campuses. The system serves the needs of patients across Upstate South Carolina and southwestern North Carolina. SMC is an American College of Surgeons verified Level I Trauma Center and currently provides trauma care for seven different counties. SMC serves as a tertiary referral center, providing a full range of medical and surgical services. We have five intensive care units (ICU) containing 54 beds dedicated to the care of critically ill patients. Our system supports the involvement of a critical care team on each patient admitted to the ICU.
The SCC fellow will spend at least 10 months on the SCC service and has the option of up to two months of electives. The fellowship offers a number of elective rotations such as Trauma/Acute care surgery, Cardiovascular Critical Care, Medical Critical Care, and Pediatric Critical Care. The SCC fellow is required to have completed an ACGME accredited general surgery program and be board eligible or board certified in general surgery.
The SCC faculty consists of five SCC fellowship-trained surgeons. The SCC service provides consultative services for critically ill and high-risk surgical, trauma and neurosurgical patients including pre-, peri-, and postoperative evaluation and management, as well as performance of bedside and operative procedures for high-risk and acutely ill patients. The SCC service, together with the general surgery residency program, provides 24-hour-a-day in-house physician management of critically ill patients.
The SCC service is a graduated responsibility system and the SCC fellow is primarily responsible for supervision of the SCC team as a senior trainee. The service typically includes a PGY 2 or 3 surgery resident, a PGY 1 transitional resident as well as fourth-year medical students. As the year progresses the SCC fellow is given more independent activity but will continue to work cooperatively with the SCC faculty.
The 24-bed Pavilion 5 Adult Critical Care Unit is the primary unit that admits trauma, surgical and neurosurgical patients. The SCC service will also care for patients in the 26-bed Medical Critical Care ICU and the 10-bed Cardiovascular ICU as consulted. These patients provide the core foundation for critical care education throughout the fellowship. Fellows are expected to become proficient in bedside ultrasound. Experience with ECMO and cardiac assist devices is available to the fellow.
The program is heavily based on clinical practice and unit administration, but offers ample opportunity for clinical research to those who are interested. We have a robust didactic education program, including professional development, research and guideline development. Fellows are expected to participate in clinical research projects and to submit abstracts to, and attend, a major critical care meeting each year.