Applicants are invited to apply for two fellowship positions in Acute Care Surgery. Brigham and Women's Hospital (BWH) is verified as a level I adult trauma center by the ACS Committee on Trauma and as an adult burn center by the American Burn Association. More than 2,000 adult trauma patients and 1,500 non-trauma emergency surgery patients are managed by the Hospital annually. Extensive clinical and basic science research opportunities are available.
BWH offers a two-year Acute Care Surgery and Surgical Critical Care Fellowship track: The first year will be spent in the ACGME-accredited Surgical Critical Care Fellowship, leading to eligibility for the ABS Certificate in Surgical Critical Care. The second year is based on the AAST Acute Care Surgery curriculum and focuses on trauma and non-trauma emergency surgery. This format provides broad-based experience in general, vascular, and thoracic surgery, as well as training in damage control orthopedics and essential neurosurgical procedures. (This non-ACGME fellowship year is also available as a one-year fellowship.)
Acute Care Surgery Fellowships are intended for general surgeons eligible for certification by the American Board of Surgery (ABS) with interest in an academic career in acute care surgery.
The Acute Care Surgery Fellowship was developed by Dr. Edward Kelly and Dr. Selwyn O. Rogers, Jr. (former chief of the Division of Trauma, Burn, and Surgical Critical Care) and the Division's trauma, burn, emergency surgery, and surgical critical care faculty members.
The Division of Trauma, Burn, and Surgical Critical Care seeks to train general surgeons that demonstrate a strong aptitude for and commitment to an academic career in trauma and emergency surgery. Its objective is to produce clinical and investigative leaders in this emerging specialty, to actively participate in national efforts to develop an ACGME-approved fellowship, and to contribute more broadly to the dialogue regarding the appropriate scope of work for acute care surgeons.
Half of the fellowship year will be spent in six one-month rotations in General Surgery and Trauma Surgery. Fellows will evaluate and treat patients independently with consultation by the senior staff, keeping records of operations and outcomes that will be discussed at the close of each month. They will also participate in bedside procedures (tracheotomy, endoscopy, ultrasound guided CVL insertion) for patients under their care. As fellows gain technical proficiency, they will become the primary instructors of these skills for the residents on the Surgical Services.
The other half of the fellowship year will be spent in rotations in the Burn Unit, Orthopedics, Neurosurgery, and Vascular Surgery. Fellows will rotate on these services and participate in emergency cases involving these specialties, as described briefly below:
Burn care (two blocks)--focusing on the initial resuscitation, excision and grafting, reconstruction, and postoperative management (jointly with residents on the burn service) and the evaluation and treatment of burn patients in consultation with one of three primary burn surgeons.
Orthopedics (two blocks)--focusing on gaining experience with acute orthopedic conditions such as fracture/dislocation, joint relocation, emergency splint application, application of traction splints and traction pins, and femur and pelvic fractures.
Neurosurgery (one block)--focusing on traumatic brain injury and acute spinal cord injury, and specifically decompressive craniotomy, insertion of intracranial pressure monitors, and application of spinal traction.
Vascular surgery (one block)--focusing on acute surgical vascular conditions such as acute arterial occlusive disease, ruptured aneurysm, and vascular trauma and gaining familiarity with vascular duplex ultrasound, insertion of vena cava filter devices, operative exposure of the spine, and duplex ultrasound evaluation of arterial and venous disease.
In addition to the daily teaching in the OR, on the floors, and in the ambulatory areas, there are regular didactic sessions in general surgery as well as the subspecialties. On Wednesday mornings, there is a morbidity and mortality conference that faculty and trainees attend, followed by Surgical Grand Rounds featuring speakers of national prominence on a wide variety of topics and advances in the surgical field.
Fellows will also participate in weekly Trauma rounds, monthly Trauma Peer Review Committee Meetings, monthly Trauma and Burn Performance Improvement Committee Meetings, and monthly Burn Management Meetings. During surgical rotations, fellows will be responsible for preparing a lecture every six weeks.
Fellows will be expected to conduct an independent research project in clinical outcomes, basic science, surgical innovation, surgical education, or clinical guideline development. Fellows may choose from ongoing clinical investigations.
In addition, the Division's trauma attendings have clinical research underway regarding retrievable IVC filters, catheter related sepsis, sedation and delirium, and the trauma care policy for traumatic brain injury. Opportunities also exist for participation in drug trial research, clinical guideline development, surgical education research, anesthesia research, and translational research.
Please contact the Program Director with questions about specific research interests, or visit the BWH Department of Surgery Research website.
Each fellow will meet on a monthly basis with the Program Director to discuss clinical, academic, and professional progress. The Program Director will share informal feedback at these regular meetings, and at least quarterly, will share formal feedback from the attendings evaluating the fellow. Fellows will sign this written feedback as acknowledgment of its receipt. The Program Director will provide formal career mentorship as well, and include as appropriate, mentors in general surgery and other related specialties. This mentorship could include advice on career development, nomination to national surgical societies, sponsorship for surgical meetings, guidance on research projects, and help with obtaining research funding. Each fellow will have a mentorship plan tailored to his/her specific academic career goals.
Fellows will be closely supervised within a structured system that includes daily rounds and the constant availability of an attending for review and consultation. Similarly, all operative cases will be discussed and planned in consultation with the Program Director or another trauma attending. One senior faculty member will be available as a backup for the fellow in the operating room. Appropriate surgical faculty members will be involved for specialized cases (e.g., thoracic, vascular, advanced laparoscopy, endocrine, etc.). All complications will be presented and discussed in the regularly scheduled Morbidity and Mortality meetings, Trauma Peer Review meetings, and Trauma Performance Improvement Committee meetings. There will be a backup schedule to cover the fellow when he/she is taking call for trauma/emergency surgery.
Fellows' schedules will meet the following duty hour requirements:
* Work weeks no more than 80 hours
* At least one day off per week
* Consecutive work hours no greater than 24 hours
* Minimum of 10 hours between shifts
Fellows will take trauma/emergency surgery call no more than 7 times per month. While on call, a fellow will be responsible for taking care of all trauma and emergency surgery admissions, as well as responding to requests for surgical consults.
Fellows will be compensated according to the Partners Resident Salary Scale at PGY level 6, eligible for BWPO fringe benefits, and entitled to three weeks of vacation and two weeks of sponsored CME activities.
Fellows will comply with Brigham and Women's Physicians Organization (BWPO) billing procedures and must agree that only the BWPO can claim or receive any fees for services.
The program invites applications from candidates who will have completed a general surgery residency and be board eligible in the United States or Canada by the start of the fellowship. Candidates most strongly demonstrating an aptitude for and commitment to an academic career in acute care surgery will be invited to interview in person.
Brigham and Women's Hospital is an equal opportunity/affirmative action employer. Women and members of minority groups are encouraged to apply.
Applications must include:
Applications will be accepted in their entirety via email to BWHACSfellowship [at] partners.org (no unsolicited ads) or at the following address until the positions are filled:
Edward Kelly, M.D., ACS Fellowship Program Director
Division of Trauma, Burn, and Surgical Critical Care
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Dr. Kelly and a panel of Trauma attendings will comprise the selection committee. Applications will be reviewed as they are received.
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