Trauma & Acute Care Surgery Anesthesia Fellowship

Program Directors: Vincent Lew and Katrina Gabriel-Ramos

University of California, San Francisco/Zuckerberg San Francisco General Hospital 

Trauma & Acute Care Anesthesia Fellowship

The UCSF/ZSFG Trauma & Acute Care Anesthesia Fellowship is designed to prepare junior Attending Anesthesiologists with the foundational skills and experience to become leaders in the field of Trauma Anesthesia & the preparation and management of the emergency surgical patient. 

Desired Qualities

  • Exceptional team member with focus on clinical leadership
  • High performing communicator
  • Passionate about quality improvement
  • Desire to provide equitable health care
  • Nuanced understanding of physiology under stress and its management
  • Motivated and passionate educator

Structure
The Trauma & Acute Care Surgery Anesthesia Fellowship is a 12-month clinical, non-ACGME accredited fellowship. Fellows will be employed by UCSF as a Clinical Instructor and work an average of two to three days per week as an Attending Anesthesiologist to provide salary support. The remainder of the week will be devoted to research and educational activities. Many of these educational activities will involve clinical work in a supervised capacity. 
The educational program will be divided into modules. Four core modules will be completed over the year, and a selection of elective modules will be undertaken in-line with the Fellow’s interests. The exact personalized structure of the year will be determined before the commencement of the fellowship between the Fellowship Director and the Fellow.

Core

1. Trauma Physiology, Coagulation and Management 

a. A combination of self-directed learning, didactic lectures, teaching opportunities & practical skills development, including point-of-care coagulation testing

2. Perioperative Cardiac Ultrasound

a. Completion of the ECO 1 Course in Clinical Echocardiography and Ultrasound offered by www.iteachu.com in conjunction with the Society of Cardiovascular Anesthesiologists. The Fellow should be able to sit for the National Board of Echocardiography Basic PTE Certification exam by end of year.

3. Non-technical Skills in Trauma and Critical Events

a. Mentorship in the management of critical incidents. Develop a toolbox of strategies to ensure personal and team optimal performance.

b. Participate and educate in Resident Simulations with a focus on non-technical skills development

4. Professionalism & Leadership – Inside and Outside the OR

a. Exposure to anesthesia and hospital management. Experience and involvement in the LEAN management process as applied to the OR.

Electives

1. Advanced Trauma Diagnostics & Procedures

a. Coursework in Trauma Radiology (CT/XRay). Dedicated hands-on experience in the Emergency Department performing diagnostic ultrasound and FAST scans.

2. Quality Improvement

a. The Fellow will engage in a yearlong project focusing on an area of improvement for the Department of Anesthesia with a focus on emergency surgery and trauma. Examples of potential projects include – fasting times for emergency surgery; Post-Operative Analgesia in the Complex Pain Patient; Blood Transfusion management in the OR.

3. Research 

a. The Fellow will join in existing clinical or translational science projects. They will have an opportunity to write or contribute to an IRB, data collection, analysis, or write up. The specific exposure will depend on current project status. Fellows will have an opportunity to participate in hypothesis generation, but are unlikely to complete a full project within the scope of their fellowship year. 

4. Trauma in resource poor settings 

a. The Fellow will actively engage with the Center for Global Surgical Studies @ UCSF. Depending on active projects and funding availability there may be opportunities to travel to Kampala, Uganda or the Navaho Nation to compare and contrast Trauma systems in resource poor settings.

5. Pain Management & Regional Anesthesia in Trauma

a. The Fellow will be scheduled with the regional anesthesia team with a mixture of resident supervision and self-performed blocks. They should get experience in paravertebral catheters and the role of regional anesthesia in acute traumatic pain management. In addition, they will have some exposure to the In-Patient Acute Pain Service that manages all catheter related pain issues in surgical and trauma patients. 

6. Pediatric Trauma

a. This module will involve a clinical rotation to Children’s Hospital Oakland (CHO). The Fellow will undertake one day per week for 6-8 weeks. The Fellow will participate in elective and emergency pediatric anesthesia gaining additional exposure to vascular access, transfusion and pediatric trauma. This opportunity is conditional on the Fellow being able to successful acquire credentials at CHO.