The Unit
Description
The University of Texas Health Science Center at Houston (UTHSCH) is one of only two ACS-verified level 1-trauma centers serving Houston, Texas, the fourth largest city in the United States. The trauma center and main teaching institution is located at Memorial Hermann Hospital, an 800-bed facility within Texas Medical City. It is home of Life Flight aero-medical services and the John S. Dunn Helistop, the busiest heliport in the United States for its size. UTHSC admits well over 5,000 trauma patients annually with the most severely injured cared for in the 25-bed Shock-Trauma ICU (STICU). The fellowship was initiated in 1994 and currently supports three (3) Surgical Critical Care Fellows (with a request to ACGME to expand to six), three (3) research fellows, and one to two Clinical Trauma Fellows. The Acute Care Surgery Division has eleven (11) faculty members. We offer multiple fellowship opportunities ranging from purely clinical to those with a research emphasis. One-year fellowship positions in (1) Surgical Critical Care, (2) Clinical Trauma or (2) Trauma Research are available. In addition, two-year positions are available in (1) Surgical Critical Care and Clinical Trauma, (2) Surgical Critical Care and Trauma Research, and (3) Two-year Trauma Research (T32).
Research Activities
The U.S. Department of Defense, Army Institute of Surgical Research has awarded The University of Texas Health Science Center at Houston funds to conduct a multi-site observational study of severely injured trauma patients who require blood transfusions. This study will benefit future severely injured trauma patients by helping determine the best early method of identifying patients who would benefit from receiving different ratios of red blood cells to plasma to platelets. This study will also identify what massive transfusion protocols exist in 10 leading trauma centers and which protocols are associated with better survival. Results of this study will inform development of a future randomized clinical trial which will test these protocols.
The T32 funding mechanism is a federally funded grant mechanism to develop the careers of promising young scientists. Each T32 program has a specific focus, and UTHSCH was awarded this grant in 2001 to investigate the Role of the Gut in Multiple Organ Failure.Since it’s creation, the focus of the research has evolved and is now aimed at the role of plasma in hemorrhagic shock. Currently, three trainees (with a Ph.D. or M.D.) devote themselves for two years to basic science, bench, and clinical research. Funding for renewal was granted in 2006, and currently, Dr. Holcomb is the Principle Investigator of this program. The success of the T32 is due to the combined efforts of faculty members and collaborators.
Fellowship Program
Clinical Responsibilities
The majority of the Surgical Critical Care year is spent in the STICU, allowing exposure to a wide variety of severely injured patients, often with multiple co-morbid conditions. Additionally, the STICU serves as the highest level of care for critically ill patients from general surgery services, head and neck surgery, and obstetrics and gynecology. The STICU has approximately 975 admissions annually. Other rotations such as the medical ICU, cardiovascular ICU, Neuro-trauma ICU, Burn ICU and Pediatric ICU enhance exposure to a wide variety of patient populations and ICU practices. The Clinical Trauma Fellowship is individualized to each applicant and is focused on developing their future practice whether it will be in academics or a private setting. The year is also customized to address specific deficits that the candidate feels that he/she might have with respect to operative, non-operative, and interventional management.
Critical reviews of research and the medical literature form an integral part of the daily ICU bedside teaching rounds and didactic conferences. Each Monday both administrative and research issues are addressed at the Trauma/Critical Care Faculty Meeting. In addition, changes in practice and proposed research topics are discussed in detail at the monthly Practice Management Guidelines meeting. Recently implemented Surgical Critical Care Conference and the Trauma Operative Conference deliver Grand Rounds-quality lectures by the institution’s (and visiting) Faculty that are aimed specifically at “fellow-level” education (PGY-6 and above). The SCC resident is expected to deliver at least one Grand Rounds lecture throughout the year.
Research Opportunities
Research opportunities are numerous and are supported and driven by the two trauma research enterprises within UTHSC. The first is a robust basic science laboratory that focuses on hemorrhagic shock and its optimal resuscitation. Drs. John Holcomb and Rosemary Kozar lead this lab clinically, while Drs. Charles Wade and Shibani Pati direct its laboratory structure and efforts. Charlie Wade, Ph.D., has recently joined our faculty from the U.S. Army Institute for Surgical Research, Fort Sam Houston, TX. The majority of Dr. Wade’s research has focused on aspects that will be immediately translatable to the care of soldiers on the battlefield and improve outcomes of injured civilians. Dr. Wade’s collaborative relationship with Dr. Holcomb, in addition to his research and translational medicine research, provides him with the expertise and experience to serve in the role of support faculty on the T32 training program. The T32 fellowship in research is a federally funded grant mechanism to develop the careers of promising young scientists. Each T32 program has a specific focus, and UTHSCH was awarded this grant in 2001 to investigate the Role of the Gut in Multiple Organ Failure. Since it’s creation, the focus of the research has evolved and is now aimed at the role of plasma in hemorrhagic shock. Currently, three trainees (with a Ph.D. or M.D.) devote themselves for two years to basic science, bench, and clinical research. (see past and current Fellows) Funding for renewal was granted in 2006, and currently, Dr. Holcomb is the Principle Investigator of this program. The success of the T32 is due to the combined efforts of faculty members and collaborators.
The second component of the research enterprise is supported and led by the Center for Translational Injury Research (CeTIR). Funds from the Texas Emerging Technology Fund, The University of Texas Health Science Center at Houston and the Memorial Hermann Hospital Fund established CeTIR in 2008. The principle mission of our center is to lead in the research and development of next-generation medical technologies related to hemostasis, resuscitation, and computerized decision support for trauma patients. The need for translating trauma research from the bench to the bedside is as great a priority and CeTIR is in a unique position to link basic science research to clinical practice. Faculty from the center have numerous research projects available for participation and ownership by the Fellows. The Center currently employs not only clinical scientists, but epidemiologist and biostatisticians as well. The fields of interest range from development of models to rapidly predict massive transfusion to the multi-center assessment of the utility of Rapid Thromboelastography to identify coagulation defects in the acutely injured patient to outcomes based research topics and performance improvement projects. Investigators from the Division of Acute Care Surgery and CeTIR have authored 250 peer-reviewed articles in the past two years.The
SCC resident is also encouraged to participate in ongoing projects and to develop their own research interests. Research time is made available on an individual basis to those residents who wish to further their own scientific investigations.
For a list of ongoing activities, please visit: http://www.uth.tmc.edu/cetir/projects.html
Teaching Responsibilities
The fellow will direct rounds and education of the residents and students on service. These include residents from General Surgery, Surgical Sub-specialties, Anesthesia, and Emergency Medicine. As well, residents in Pharmacology programs and senior medical students are on service.
Certifications
Upon completion of the Surgical Critical Care fellowship year, the individual will be eligible for the American Board of Surgery Surgical Critical Care Boards or European Critical Care Boards
Salary
$51,336 USD for the Surgical Critical Care fellowship yearApplicant Requirements
For Surgical Critical Care and Clinical Trauma Fellowship:
1. Completion of a General Surgery Residency
2. Board Eligible or Board Certified General Surgeon or Surgical Subspecialty
Contact
Bryan Cotton
Center for Translational Injury Research (CeTIR)
The University of Texas Health Science Center
6410 Fannin Suite
1100 UPB
Houston, Texas 77030
USA
Phone: 713-500-7354
Fax: 713-512-7135
Email: .(JavaScript must be enabled to view this email address)
URL: http://utsurg.uth.tmc.edu/fellowships/critical_care.html
Jun 25, 2010
