Curriculum

surgical critical care fellowship

Program Philosophy The University of Hawaii Surgical Critical Care Fellowship Program seeks to prepare the SCC fellow to become a dedicated surgical intensivist who will continue to carry on the spirit of teaching as well as to strive for improving patient care. The year spent in the Surgical Intensive Care Unit will be an educational and growing experience for the SCC fellow. The SCC fellow will be the central contact person for the residents, nurses, attendings, consultants and other ancillary services. Besides mastering the clinical knowledge of intensive care medicine, the SCC fellow will grow as a teacher, administrator, arbitrator, and researcher. Due to the nature of critical care medicine, difficult political and ethical issues will be part of the daily experience. At some point during the year, the SCC fellow will begin to act the role of an attending. This metamorphosis in roles comes from gaining knowledge, respect from colleagues and self-confidence.

Program Organization The Surgical Critical Care Fellowship Program (the Program) is an approved one-year adult surgical critical care training program, under the auspices of the University of Hawaii John A. Burns School of Medicine. The prerequisite for applicants is completion of an approved general surgery residency or minimum of three years of general surgery residency with a position to finish the last two years after fellowship. The Program is accredited by the Accreditation Council for Graduate Medical Education. Acceptance is made through the National Resident Matching Program (NRMP). All applicants must apply through Electronic Residency Application Service (ERAS). The program utilizes the facilities of community-based hospitals. All facilities are modern, fully equipped and staffed, and are an integral part of the overall program. The Program Director is responsible for Program management and has the required authority to arrange for adequate teaching facilities, teaching staff, resident staff, educational resources and the materials and research facilities. Each academic year begins July 1 and ends June 30.

Program Description and Curriculum The Program is designed to teach competency in Adult Surgical Critical Care. Nine and a half months are spent in the adult SICU at the Queen’s Medical Center, one month in the neonatal/pediatric ICU at Kapiolani Medical Center, one month in the burn unit at the University of California Davis Medical Center and Shriners Hospitals for Children, Northern California, and 2 weeks in cardiac surgery at St. Francis Medical Center, and with exposure to transplant throughout the year depending on donor availability at St. Francis Medical Center. The SICU at the Queen’s Medical Center is the parent unit. Patient contribution from many surgical specialties (general surgery, trauma, vascular, thoracic, orthopaedic, neurosurgery, urology, ENT, and Ob-Gyn services) allows exposure to a diverse group of patients. The goals of these rotations are to assess and manage critically ill or injured patients and to be able to assess accurately and evaluate high risk surgical patients.

Research Research Meetings are held at least once a month. The Queen’s Medical Center has a well organized research department to assist with design, implementation, statistical analysis, computer data entry, and legal counseling associated with research. The SCC fellow is active in the field of Critical Care Research.

Service The training of the SCC fellow takes place primarily in three affiliated community hospitals: The Queen’s Medical Center, St. Francis Medical Center, and Kapiolani Medical Center. The SCC fellow is assigned to the University of California Davis Medical Center and Shriners Hospitals for Children, Northern California for a one-month burn rotation. On-call duty occurs approximately every third night.

Faculty Attendings assigned as the core teaching staff to the surgical intensive care unit are physicians related to the area of surgery and/or critical care who have been trained in a formal fellowship and have passed or is eligible for critical care boards. They are dedicated teachers with the purpose of communicating knowledge and promoting critical thinking. They are also responsible for maintaining expertise in their own knowledge base, are involved in research projects, and resolve controversies through science and research. By practicing quality of care, as well as demonstrating an ethical and humane approach to the critically ill, attendings serve as role models for young physicians in training. The Department of Surgery of the University of Hawaii John A. Burns School of Medicine is the parent program for the Surgical Critical Care Fellowship. The Chairman of the Department of Surgery/Program Director of the University of Hawaii Surgical Residency Program is Danny M. Takanishi, Jr., M.D., Associate Professor of Surgery. The Program Director of the Surgical Critical Care Fellowship is Mihae Yu, M.D., Professor of Surgery. Dr. Yu is also the Director of Surgical Critical Care Unit at the Queen’s Medical Center. She is a member of the Special Care Committee which is a hospital committee comprising of representative from all the ICU’s as well as other disciplines (nursing, respiratory, pharmacy, trauma, and telemetry). Other hospital/medical staff committee involvement consist of: Critical Care Peer Review, Medication Use Committee, Respiratory Therapy, General Surgery, Trauma Committee, Trauma Peer Review, and the Medical Executive Committee. Hao Chih Ho, M.D., Assistant Professor of Surgery, is the Associate Program Director of the Surgical Critical Care Fellowship. Maimona Ghows, M.D., Assistant Professor of Surgery and Director of Anesthesia for the University of Hawaii Surgical Residency Program, is also the Associate Director of the Surgical Critical Care Fellowship Program. Numerous ancillary faculty members also contribute to the teaching and academic environment.

Continuing Education The SCC fellow is expected to attend monthly conferences including basic science, clinical science, journal club, grand rounds, morbidity and mortality, Hawaii Critical Care conferences, infectious disease lectures, neuroscience lectures, respiratory therapy department ventilator workshops, and research meetings. The SCC fellow may attend one conference in the field of critical care, usually the Society of Critical Care Medicine conference held in January/February. The Program may fund additional travel to conferences where papers are presented.

Contact Iinformation e-mail contact: mihaey@hawaii.edu or sccprogm@hawaii.edu University of Hawaii Surgical Critical Care Fellowship Program 1356 Lusitana Street, 6th Floor Honolulu, Hawaii 96813 Telephone: (808)586-2920 Fax: (808)586-3022 Toll Free: 1-888-584-7874 (5UHSURG)

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