Program in Trauma
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Extracorporeal Life Support Fellowship
ECLS Curriculum
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ECLS Schedule

Didactic Schedule

ECLS Rotation Schedule

Fellows will spend a majority of clinical “fellow” time in Cardiac Surgery ICU (CSICU), with graduated responsibilities throughout the year. Elective time is typically focused on cardiac extracorporeal support rotations. Elective time is flexible, but rotations including interventional cardiology, advanced heart failure service, interventional pulmonology, and trauma endovascular are popular.

The fellowship is not ACGME accredited and fellows will have appointments at the clinical instructor level in the appropriate department. Fellows will spend time as an attending intensivist one week a month in the Multi-Trauma Critical Care (MTCC) Unit on the VV ECMO side. Two weeks per month will be spent as a fellow on various rotations and electives. The remaining week is non-clinical for administrative and research time. Moonlighting opportunities exist at our community sites in the ICU

*In-person orientation will occur around July 20

 

Monthly Rotation Attending Week
Orientation MTCC
MTCC-ECMO (J) MTCC
CSICU (F) MTCC
CSICU (F) MTCC
Advanced Heart Failure MTCC-ECMO
CSICU (F) MTCC-ECMO
Interventional Cards CCRU
CSICU (J) MTCC-ECMO
Trauma Vascular MTCC-ECMO
CSICU (J) CCRU
Elective MTCC
CSICU (J) MTCC-ECMO

 

F = Fellow/Provider
J = Junior Attending

Second Year Training Pathways

Second Year Training Pathways

EM-SCC fellows are asked to designate a specific pathway, based on their future career interests in either surgical critical care or cardiac surgery critical care. The pathways are designed to help the fellow best prepare for their future roles in the critical care environment. The preliminary year is the same, regardless of pathway, and fellows are not asked to designate a pathway until their semi-annual review in the early calendar year.

Surgical Critical Care (SCC) Pathway

The Surgical Critical Care Pathway emphasizes more traditional surgical critical care environments.

The first year includes at least eight months of critical care training with time on the Trauma Teams, vascular services, and the Acute Care Emergency Surgery (ACES) service, as well as many others. The remaining four months are composed of critical care months within the Shock Trauma Center.

The second year is predominantly focused on critical care, with nearly 10 months of critical care rotations ranging from trauma to cardiac to surgical critical care. By the end of the second year, the fellow will be well prepared to sit for the SCC board examination, as well as begin their career as a surgical critical care intensivist.

EM-SCC Surgical Critical Care Training Pathway: Second-Year Rotations

Rotation Duration
Multi-Trauma Critical Care (MTCC) 2 months
Neuro-Trauma Critical Care (NTCC) 2 months
Surgical ICU (SICU) 2 months
Cardiac Surgery ICU (CSICU) 1 month
Trauma Teams 2 months
Critical Care Echocardiography 1 month
Anesthesia 0.5 month
Palliative Care 0.5 month
Elective 1 month

Cardiac Surgery Critical Care (CSCC) Pathway

The Cardiac Surgery Critical Care Pathway allows the fellow to focus their experience on advanced cardiac disease and mechanical support while also integrating the traditional surgical critical care rotations.

EM-SCC Cardiac Surgical Critical Care Training Pathway: Second-Year Rotations

Rotation Duration
Multi-Trauma Critical Care (MTCC) 2 months
Neuro-Trauma Critical Care (NTCC) 1 month
Surgical ICU (SICU) 1 month
Cardiac Surgery ICU (CSICU) 3 months
Trauma Teams 2 months
Critical Care Echocardiography 1 month
Anesthesia 0.5 month
Palliative Care 0.5 month
Elective 1 month

Rotations

Trauma Teams

STC is the busiest trauma center in the state of Maryland, allowing fellows to evaluate and treat the sickest population of trauma patients in our state-of-the-art trauma resuscitation unit (TRU) during their two months on the trauma service. The TRU is made up of 13 dedicated trauma beds managed by trauma nurses, trauma anesthesiologists, the trauma team, and our trauma radiologists. The fellow on the Trauma service is responsible for leading the team of residents (surgical and EM). During a busy and exciting month, you are responsible for admitting all trauma patients when on call, running trauma resuscitations, managing the trauma bays, and overseeing your team in the care of all trauma patients on your service.
Trauma Surgery at UMMC >

 

 

Acute Care Emergency Surgery

As a first-year fellow, you will be an active member of the surgical team on the Acute Care Emergency Surgery Service. You will be rounding with the surgical team and consulting on medically complex and critically ill patients, as well as operatively assisting in cases including appendectomy, cholecystectomy, bowel ischemia and abdominal compartment syndrome.
Acute Care Surgery at UMMC >

 

 

Cardiac Surgery

Rotation on the Cardiac Surgery Service will involve collaborative care of post-operative patients in the CSICU as well as a substantial amount of time in the operating room participating in a wide variety of cases. Aortic dissections, coronary bypass grafting, and valve replacements are among the basics of what you’ll see this month. During this month, you will also have the opportunity to observe and learn from cardiac anesthesia and perfusionists, and observe intraoperative TEE.
Cardiac Surgery at UMMC >

 

 

Soft Tissue Service

Shock Trauma has a team dedicated to the care of soft tissue infections. While rotating on this service, you will have the opportunity to learn about extensive necrotizing wound infections, participate in operative debridement, and provide wound care for complex and often large wounds, as well as participate in reconstructive efforts for these wounds.
Soft Tissue Infection Service at UMMC >

 

 

Vascular Surgery (Trauma Vascular/Endovascular)

The aim of this rotation is to provide a month of exposure to basic endovascular and vascular surgical treatment of injury as well as hemorrhage control in the injured or critically ill patient. Fellows will participate in all activities of the service, which include the evaluation of patients, operative planning, intraoperative decision-making, and postoperative care, as well as outpatient surveillance and follow-up visits.
Vascular Surgery at UMMC >

 

 

Critical Care Resuscitation Unit & Surgical Resuscitation

A novel unit dedicated to the rapid assessment and care of critically ill patients transferred from other institutions, the CCRU is a six-bed unit designed to admit the highest acuity patients for stabilizing and facilitating the definitive care they require. The unit has broad expertise to care for a wide variety of diagnoses including vascular disasters, shock, conditions requiring ECMO support, intracranial hemorrhage, ischemic strokes, acute fulminant hepatic failure, and obstetrical emergencies.
CCRU at UMMC >

 

 

Anesthesia

During this rotation, the fellow will be partnered with a group of University of Maryland School of Medicine anesthesiologists to become more familiar with perioperative sedation, analgesia and paralytic medications as deemed appropriate for the clinical situation. Fellows will learn and apply various airway assessment scoring systems, how to maintain an open airway and provide adequate bag-mask ventilation, learn proper airway manipulation and intubation with and without a laryngoscope, and perform alternatives to conventional endotracheal ventilation, such as Bougie-assisted placement.
Trauma Anesthesiology at UMMC >

 

 

Echo

Working directly with a skilled ultrasonographer, fellows will learn how to complete a full echocardiographic examination, interpret the data collected, and make recommendations on fluid status and fluid responsiveness. By the end of the rotation, fellows will have a strong foundation of TTE.

 

Rotation Elective Options