Surgical Critical Care Fellowship program

Character of the institution: Loyola University Medical Center (LUMC), affiliated with Loyola University Chicago Stritch School of Medicine is a tertiary care teaching hospital with 542 licensed beds. The Department of Surgery is RRC approved for six categorical general surgical residency positions per year. Surgical fellowships approved include: vascular surgery (1 position/year), cardio-thoracic surgery (2 positions/year), plastic surgery (1 position/year), and surgical critical care (1 position/year).

Loyola is the only major university-affiliated medical center in the western suburbs of Chicago, serving a catchment area of 5 million people. Loyola serves as a major referral site for complex general surgery patients as well as critically injured patients. Loyola is a state-designated Level I Trauma Center for both adult and pediatric patients, admitting approximately 1800 injured patients per year and supported by an active aeromedical program. Loyola’s Burn Center treats over 400 patients a year, making it the busiest burn center in metropolitan Chicago and the Midwest, and the first Burn Center in the area verified by the American Burn Association/American College of Surgeons. Finally, the Emergency Department provides treatment to approximately 50,000 seriously ill and injured patients every year.

The Department of Surgery at LUMC has consistently maintained a rigorous academic environment for surgical residents. The number of critically ill patients managed at LUMC has steadily increased. The maturation of the intraabdominal and intra-thoracic transplantation programs has provided further experience in handling complex patients. Along with the expansion of the trauma service, and the high volume of complex surgical cases, the Loyola experience and educational possibilities in critical care have been excellent.

Level I Trauma Center Designation
The Loyola University Medical Center has been verified by the American College of Surgeons (ACS) as a Level I Trauma Center, the only ACS verified trauma center in the State of Illinois. The verification is valid for a three-year duration. This additional accolade supplements the state of Illinois designation as a Level I Trauma Center, delivering the highest standards of care to injured patients.

The strong research interests of the faculty are supported by the Burn and Shock Trauma Institute (BSTI). The BSTI is a multidisciplinary research entity dedicated to the prevention and treatment of injury and its consequences. Its research efforts further complement the emphasis on critical care and teaching. The focal point of the Institute’s activities is a state-of-the-art research facility, with 12 independent research laboratories. A hallmark of the Institute is the strong coupling of several basic science disciplines with clinical applications. This linkage is emphasized in the development of joint projects between clinicians and basic scientists, resulting in translational research, taking the bench top to the bedside. This collaborative environment is further enhanced through intramural bridge grants between laboratories, a weekly research forum, and an NIH-funded Trauma Training Grant. Additionally, the Institute is the home of the Loyola Injury Prevention Program, which develops and conducts community based injury prevention programs.

The Surgical Critical Care fellowship is integrated into the general surgical residency at several levels. The SCC fellow serves in a “junior attending” capacity in the SICU. The fellow supervises residents at the 1st, 2nd and 4th year levels of residency. Regular responsibilities include daily rounds, didactic lectures, with performance and supervision of procedures. The SCC fellow is an integral member of the Critical Care team, providing continuity of care, and an important interface between the critically ill patient and members of the operating team. Additionally, the SCC fellow has the opportunity to obtain mastery of the organizational and administrative aspects of a critical care unit, and the ethical, economic and legal issues that pertain to critical care. At the completion of the program, the SCC fellow will understand the administration of an intensive care unit, be able to establish policies and procedures for that unit, and will also be facile in the implementation of a performance improvement program.

The structure of the critical care program at LUMC is such that the SCC fellow has primary responsibilities in the ICUs. The operative experience primarily occurs during the 5 nights of trauma call per month. The SCC fellow will also be involved in ICU-based procedures in a supervisory role, as well as with critically ill trauma patients who may require re-exploration.

The main ICU is the Surgical Intensive Care unit at LUMC, a 16-bed ICU and 8-bed step-down unit which runs at 97% occupancy. The mix of patients is approximately 40% multi-system trauma patients and 60% general surgery patients, with occasional orthopaedic and gynecological emergencies. The SCC fellow spends at least 7 months in this ICU. The ICU resident and team co-manage the patients in the SICU with the primary service. All comprehensive critical care issues are managed by the ICU team and SCC fellow, while the routine general surgery issues such as wound management, etc. are managed by the primary team. A collaborative effort is given towards issues such as nutritional support and antimicrobial therapy.

The Hines VA surgical intensive care unit is an 8-bed unit with both cardiothoracic and general surgical patients. The SCC fellow spends 2 months in this ICU. The Hines VA ICU works with a similar collaborative care model to the LUMC ICU.

The Burn Unit at Loyola is a 10-bed ICU dedicated to the management of critically burned patients. This unit runs at greater than 95% occupancy. This rotation is an optional one or two month rotation for the fellow, depending on the level of interest. The SCC fellow functions in a supervisory and teaching role to the mid and junior level residents in the Burn Unit.

The SCC fellow also has the opportunity to do elective rotations in the cardiothoracic unit, a multidisciplinary unit staffed by both surgical and anesthesia intensivists, in the pediatric ICU staffed by pediatric intensivists or in the medical ICU staffed by medical intensivists.

The fellowship training program is directed by Dr. John Santaniello. Dr. Santaniello also directs the Surgical ICU at LUMC. Dr. Richard Gamelli is the Director of the Burn ICU. Dr. Ellen Omi is the director of the Surgical ICU at the Hines VA hospital. The Director of the Trauma Division is Dr. Thomas Esposito.

The application process is as follows. Please complete and submit the SCC Fellowship application available at this site. All candidates must be registered through the National Resident Matching Program. Personal interviews are conducted in July, August and September of each year. The deadline for submission of Match Lists is early October and the Match results become available at the end of October or early in November.

Please note that completion of an ACGME-accredited General Surgery residency program is a prerequisite to joining our training program. More information about training for the Added Qualification in Surgical Critical Care can be found at the American Board of Surgery website: https://home.absurgery.org/default.jsp?certsccce.
In addition, the fellow must be able to obtain a permanent medical license in the State of Illinois and be legally able to accept employment. For those requiring a visa to work, Loyola University is able to accept J-1 visa sponsorship only.

For those selected to interview, a day-long visit is scheduled at which time the candidate will meet with the Program Director, Division Director, Surgical Critical Care faculty, and other members of the Surgical Critical Care team including nurses, pharmacists, social workers, dieticians, etc. A rank order list of fellowship candidates is determined by the Program Director with input from others taking into consideration the letters of support, personal interview, career goals, and credentials and experience of the candidate. This list is then submitted to the NRMP and the results are announced in October. If a position remains after the Match, the process continues. The final selection of a fellow is determined by the Program Director with input from others.

For additional information about our program, please visit our website at: http://www.stritch.luc.edu/surgery
For information about Loyola University Medical Center, please visit http://loyolamedicine.org/.

With further questions about our program, we invite you to contact:

Sheila Lawshea
Fellowship Education Coordinator,
Department of Surgery
Loyola University Medical Center
Email: slawshea@lumc.edu
Telephone: 708-327-3041
Fax: 708-327-3489