University of Wisconsin Hospitals and Clinics Program

Education of a surgical critical care fellow at the University of Wisconsin Hospitals and Clinics focuses on graduated responsibility for decision-making in patient care. The primary goal of the program is to maximize the educational experience for fellows while ensuring a commitment to patient safety and high-quality care. Throughout the duration of the fellowship, fellows earn increasing levels of independent responsibility for managing patient care with indirect supervision and oversight. The program admits a diverse patient census, offering extensive exposure across various surgical practices.

The trauma service at the University of Wisconsin Hospitals and Clinics admits over 3,500 patients annually, with approximately 800 patients being managed in the Surgical Intensive Care Unit (SICU). In addition, the transplant service handles more than 500 solid organ transplants yearly, with the surgical intensivists managing acute cases for over 100 transplants. Key facets of the fellowship include direct involvement in emergency general surgery, surgical oncology, vascular surgery, and otolaryngology services that frequently admit cases for Intensive Care Unit (ICU) management.

Fellows have opportunities to rotate through various critical care services, including the Cardiothoracic ICU, Neurocritical Care service, and Pulmonary Critical Care service. Elective rotations may be pursued in additional critical care areas such as anesthesiology, infectious diseases, nephrology, surgical nutrition, echocardiography, and burn surgery. Formal training in critical care ultrasound is part of the curriculum, with many experiences occurring at the University of Wisconsin Hospital and Clinics. Collaborative relationships with other institutions may also facilitate elective experiences beyond the main campus.

The fellows learn under the guidance of experienced faculty within the Division of Acute Care and Regional General Surgery. There is a strong collaborative relationship with the Departments of Anesthesia and Internal Medicine to enrich the fellow's educational journey. Additional educational components include monthly journal clubs, ICU mortality and morbidity conferences, weekly ICU fellow meetings, and multiple collaborative research initiatives.

Program Structure and Requirements

The Surgical Critical Care Fellowship at the University of Wisconsin Hospitals and Clinics typically spans one year, with the program accepting one fellow per year. Ideal candidates are those who have successfully completed a general surgery residency at an ACGME-accredited program. Candidates are expected to demonstrate a strong work ethic, a dedication to optimizing patient care, and innovative thinking. As fellows progress, they will develop competencies across various medical and surgical domains, including burn care, cardiovascular physiology, ethics and palliative care, and trauma management, among others.

Competency Assessment

Fellows are assessed in six core competencies: interpersonal and communication skills, medical knowledge, patient care, practice-based learning and improvement, professionalism, and systems-based practices. The program cultivates a collaborative teaching atmosphere, facilitating the development of surgeons skilled in surgical critical care.

Educational Opportunities

Beyond clinical rotations, fellows can take advantage of comprehensive educational offerings, including collaborations with different departments (Anesthesia, Internal Medicine, Neurosurgery, Surgery) for optimal learning experiences. The program incorporates clinical research, opportunities in the simulation lab, and involvement in multidisciplinary conferences such as weekly clinical meetings and quarterly Grand Rounds.

Application Process and Special Requirements

Applications for the program are accepted via the Surgical Critical Care and Acute Care Surgery Fellowship Application Service (SAFAS). Essential components of the application include a curriculum vitae, a personal statement, three letters of recommendation (with at least one letter from a clinical supervisor/mentor), and ABS In-Training examination scores. Specific application requirements may include year of graduation and maximum failed steps or exams, which should be verified in official communication channels.

Visa Support and Sponsorship

The program offers visa support for international medical graduates (IMGs) and is typically able to sponsor J-1 visas. It is advisable for prospective fellows to confirm specific visa sponsorship options during the application process.

Program Competitiveness

The Surgical Critical Care Fellowship at the University of Wisconsin Hospitals and Clinics is regarded as highly competitive. The program is open to candidates from both MD and DO backgrounds as well as international medical graduates (IMGs), contributing to a diverse applicant pool.