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This is a two year continuous program leading to dual certifications—the Accreditation Council for Graduate Medical Education (ACMGE) board certification in Surgical Critical Care (SCC) and the American Association for the Surgery of Trauma (AAST) certification for Trauma and Acute Care Surgery.
The 1st year is focused on the ACGME SCC program. The goals during this year are to develop the clinical expertise to lead and manage all aspects of a critically injured patient. Exposure to burn, bedside echocardiography, ECMO, CRRT, REBOA, Advanced Airway Management are integral to the curriculum and development of future SCC leaders. Our 10 year board pass rate is 100%.
The 2nd year is the Trauma Surgery/Acute Care Surgery Fellowship. This year is fully accredited by the American Association for the Surgery of Trauma (AAST). The emphasis during this year is on trauma, emergency complex general surgery, open vascular procedures, and trauma program development/administration. The full spectrum of combat casualty care from clinical practice to translational research is heavily emphasized. Our board pass rate for the AAST Final examination is 100% since the inception of our program. All applicants must apply for the two-year Trauma/Critical Care training program. We select 4 fellows per year.
The 1st year ACGME SCC Fellows have formal education every day. They attend a daily STICU lecture, monthly journal club, monthly reading compendium, monthly STICU M&M, Weekly PI Conference and Monthly Trauma Conference. In addition 1st year fellows are required to attend several formal courses to include a Continuous Renal Replacement Therapy (CRRT) course, an Extracorporeal Life Support (ECLS)-Extracorporeal membrane oxygenation (ECMO) course, an Advanced Airway Course, a Critical Care Ultrasound Course, and a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) course. Fellows also take the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) In-Service exam.
The 2nd year AAST Fellows are assigned a reading compendium by the AAST, complete the “Meet-theMasters” advanced trauma lecture video series, attend weekly PI and monthly trauma conferences, attend a Trauma System Orientation course, and attend a monthly ACS/trauma journal club. They also read Top Knife and read the Emergency War Surgery Handbook. Additionally, our fellows take the Asset Plus Course and attend the Emergency War Surgery Course. Select fellows are also eligible to attend the US Air Force Basic and Advanced Critical Care Air Transport (CCAT) Course. Fellows must take the AAST In-Service examination during this year.
Our fellows typically attend the SCCM conference the first year, and the AAST conference the 2nd year. We have had fellows present at the ACS, AAST, EAST, Western Trauma Association, SCCM, SOMA, Military Health System Research Symposium (MHSRS), and at other local and national meetings.
The 1st year ACGME SCC program consists of 13 block rotations devoted to advanced educational and clinical activities related to the care of critically ill patients. There is also concentration on research, process improvement, and administration of critical care units. The majority of the rotations take place in the ICUs of the TRISAT consortium hospitals (BAMC, University Hospital, and Audie Murphy VA). There are is also a rotation in McAllen Texas that focuses on STICU management and Acute Care Surgery. Fellows will participate in research and performance improvement projects during the fellowship and will be able to participate in local and national educational conferences and meetings.
The 2nd AAST ACS program consists of 12 one-month block rotations devoted to advanced educational and clinical activities related to the pre-operative, operative, and post-operative care of trauma and acute care surgery patients. Rotations on trauma, ACS/EGS, Vascular, cardiothoracic, neurosurgery, and HPB complete the year. A total of 3 months are spent away from the San Antonio area ensuring a robust case volume. Internationally, our fellows have completed elective rotations in Honduras.
The entire spectrum of battlefield care is found throughout all phases of the fellowship. Every trauma patient encounter correlates to care down-range. Our fellows participate in numerous military relevant training and educational opportunities. The weekly Theater Joint Trauma System conference is a mainstay of academics. Our fellows also have the opportunity to attend the Emergency War Surgery Course and the ASSET Plus pre-deployment course. Many of our fellows become instructors for the ASSET Plus course as well as the ATLS course. The United States Air Force Basic and Advanced Critical Care Air Transport course is also available during fellowship. The Strategic Readiness Center, San Antonio, provides pre-deployment training for our fellows. All of our fellows leave with enough knowledge, skills, and abilities to deploy at either larger combat hospitals or smaller austere surgical elements. Our fellows leave the program and become faculty at many of the US Air Force CSTARS locations and at Army Mil-Civ Level 1 Trauma Partnerships throughout the United States.
US Army, US Air Force, and US Navy Medical Corps officers who have completed a residency in General Surgery, or are scheduled to graduate from a General Surgery Residency program prior to matriculating, are eligible to apply.
Criteria for selection include academic performance in general surgery residency and medical school. USMLE/COMLEX scores, letters of recommendation, and demonstrated interest in military service with emphasis on leadership potential are strongly considered.
NLT 15 September of the year before training begins. For more detailed information on applying for Residency/Fellowship programs, contact the BAMC Medical Education Office, (210) 916-2222/3038 or DSN: 429-2222/3038
Phone: (210) 916-1682
SAUSHEC Surgical Critical Care Fellowship
Medical Education Department
Brooke Army Medical Center
3551 Roger Brooke Dr.
Fort Sam Houston, TX 78234-6200