University of Missouri-Columbia Program

The Surgical Critical Care Fellowship Program at the University of Missouri-Columbia is designed to cultivate highly skilled acute care surgeons and leaders in the field of surgical critical care. This program is set within a tertiary, ACS-verified Level 1 Trauma Center with a catchment area of over 2 million people, emphasizing a comprehensive training experience in acute surgical care.

Program Overview

The program primarily aims to train fellows in various critical care competencies, including but not limited to:

• Surgical management of severe trauma and acute surgical emergencies
• Advanced pulmonary and ventilatory management, including ECMO
• Modern resuscitation techniques
• Management of renal failure and hepatic dysfunction

Graduates of the program emerge as authorities in critical care, prepared to take on leadership roles in clinical practice, academia, and within professional organizations 1.

Curriculum Structure

The curriculum emphasizes an organ system-based approach to critical physiology, incorporating technical and non-technical skills essential for surgical critical care. Key components of the curriculum include:

• Takes part in twice-weekly Acute Care Surgery Conferences aimed at fostering critical thinking
• Weekly Critical Care Lecture Series led by fellows to enhance teaching capabilities
• Quarterly EM-ACS Conference to present crucial topics to interdisciplinary teams
• Monthly journal clubs for in-depth discussion on contemporary literature

These structured educational experiences aim to prepare fellows to engage critically in discussions, enhancing diagnostic and management skills 2.

Learning Environment

The learning environment is equipped with advanced technology and facilities, fostering high-quality care delivery. The Surgical Intensive Care Unit (SICU) is specially designed to support the educational and clinical development of fellows, providing a dedicated operating room within the ICU and a modern procedure suite 1.

Fellow Expectations

Fellows are expected to take ownership of their patients, demonstrating impeccable attention to detail while managing complex clinical cases. The program does not necessitate in-house call, but fellows are expected to be available for assistance when needed. Overall, fellows maintain a work-life balance with four days off per month

In terms of involvement, fellows are encouraged to engage actively in hospital committees, contribute to quality improvement projects, and facilitate academic discussions within the unit. Additionally, they are expected to produce at least one academic work during their training, such as a manuscript or guideline 4.

Research Opportunities

Research is a significant component of the fellowship, and fellows have numerous avenues to engage in meaningful projects. They may participate in prospective and retrospective studies led by surgeons, multi-institutional trials, and also contribute to the development of trauma and critical care systems, thereby playing a vital role in public health 3.

Mentorship and Professional Development

Mentorship is a core value of the fellowship, with an emphasis on forging productive relationships between fellows and faculty. Mentors guide fellows through their clinical training as well as in their professional growth, fostering an environment of collaboration and shared goals. Regular meetings, both formal and informal, are encouraged to facilitate these relationships 5.

Visa Support and Competitiveness

The program offers sponsorship for the necessary visa types, including J-1 and H-1B visas, supporting international applicants wishing to train in this critical care fellowship. The program is known for being highly competitive, attracting exceptional candidates, while maintaining a friendly approach towards DO graduates and international medical graduates (IMGs) 1.

Application Requirements

Special application requirements for the fellowship may include limits on the number of failed STEP exams, year of graduation, and other similar criteria. Potential applicants are encouraged to ensure they meet all necessary qualifications before applying to improve their competitiveness in the selection process 6.