Acute Care Surgery Committee Progress Report AAST Membership September 27, 2006 New Orleans
Members n n n n Gregory J. Jurkovich, M. D. , Chair (2006) Michael F. Rotondo, M. D. , Vice Chair L. D. Britt, M. D. , M. P. H. Christopher T. Born, M. D. William G. Cioffi, M. D. Thomas J. Esposito, M. D. , M. P. H. David B. Hoyt, M. D. Robert C. Mackersie, M. D. n n n n n Mark A. Malangoni, M. D. Ronald V. Maier, M. D. J. Wayne Meredith, M. D. E. Eugene Moore, M. D. Lena M. Napolitano, M. D. Grace S. Rozycki, M. D. David A. Spain, M. D. Alex B. Valadka, M. D. Sharon Gautschy (AAST executive directory) Kim Anderson Schenarts Ph. D (consultant)
Task leaders Curriculum work group: Rotondo & Jurkovich n Site selection work group: Hoyt & Jurkovich n Competency work group: Rozycki & Malangoni n
Time Line n Sept 2006 n Fall 2006 n Present curriculum outline and time line to AAST Membership Publish curriculum outline and operative requirements Complete curriculum details Write program requirements and pre-site visit check list of essentials program requirements
Time Line (cont. ) n n Jan 2007 Spring 2007 n Fall 2007 All of 2007 n July 2008 n ABS retreat; AAST retreat Site visits; Competency verification tools (tests, case logs, web-based education, etc) Interviews for fellowships Develop competency testing tools, case registry, matching program, criteria for certification of current practitioners Begin first year formal AAST ACS fellowships
Curriculum
Required Clinical Rotations Surgical Critical Care n Trauma/Surgical n Elective critical care n Emergency & Elective Surg. 6 months 3 months 15 months Total 24 months n
Suggested Clinical Rotations n n n n Acute Care Surgery Thoracic Vascular/I-R Tx/Pancreatic/Hepatobiliary Orthopedic surgery Neurosurgery Electives or maximize above n n 4 -6 m 1 -3 m 1 m 1 m 1 -3 m (suggest Burn, Peds, Endoscopy) TOTAL 15 months
Key footnotes n n n Trainees must participate in acute care surgery call no less than 12 months Flexibility in the timing of these rotations, and the structure of the 24 -m training, should be utilized to optimize the fellow’s training The rational for “out-of-system” rotations for key portions of the training must be based on educational value of the rotation Acute Care Surgery fellowship sites must have an RRC-approved SCC residency Participation in elective surgery is an essential component of the fellowship training An academic environment is mandatory and fellows should be trained to teach others and conduct research in acute care surgery
Curriculum: rotations & cases n Completed educational rotation plan 9 months critical care n 15 months advanced surgical experience elective and emergency n 4 -6 months acute care surgery n 12 months trauma/acute care surgery call n Emphasis vascular, thoracic, upper GI n Minimize ortho and neurosurgery n Finalize operative experience case list n Plan to publish in J. Trauma n
Site Selection
Interested Sites n n n n n UT Houston U. Florida U. Michigan UC-San Diego Emory U. Pennsylvania U. Washington Vanderbilt Ohio State Miami Valley/Wright St. n n n n n Maryland Shock-T Cook County/Rush UT Southwestern Michigan State U. Nevada Harvard/ MGH U. Connecticut Loyola USC UC-Irvine
Site Selection Issues (Feb 15, 2006 phone conf; August 2006 emails ) Institutional commitment n Faculty qualifications n Fellowship director qualifications n Curriculum implementation n Core competency evaluation n Educational elements n Evaluation system n Impact on general surgery training n
Site Selection group (Feb 2006 phone conf) n n n n Process should be inclusive, helpful, supportive, flexible and creative Will be some minimum, essential criteria n Eg: RRC SCC program; EGS cases Must do Emergency General Surgery Site visit inspections to identify creative training models Costs for site visits covered by application fee to AAST Not RRC-accredited at this time (financial, efficiency, flexibility) Model similar to Transplant, Oncology, Ortho trauma
Acute Care Surgery Trauma, Critical Care, and Emergency Surgery Access, Expert, Available For the best care of our patients.
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