Surgical Critical Care Fellowships

The Department of Surgery at the University of Louisville is proud to offer an ACGME-accredited Surgical Critical Care Fellowship. It is the goal of our program to produce a well-rounded surgeon with clinical competence in the care of critically ill patients.

Boasting extensive clinical experience from a broad and diverse population base, the University of Louisville Hospital is the Level-I Trauma Center that services Kentucky and Southern Indiana. While a majority of the training is completed at the University of Louisville Hospital, fellows are given the opportunity to pursue elective rotations at UofL Health – Jewish Hospital (cardiovascular ICU and transplant critical care) and Norton Children's Hospital (pediatric critical care). All sites are within a 5-minute walk from the University of Louisville Hospital.

Watch the videos below providing more details about the experience of being part of the UofL Trauma and Surgical Critical Care Fellowship Program.


https://www.youtube.com/embed/9oDTSJAMFJU

Surgical Critical Care Fellowship Program Goals

The goal of the University of Louisville Surgical Critical Care Fellowship Program is to produce a well-rounded surgeon with clinical competence in the care of critically ill patients. At the completion of the fellowship, the trainee will have factual knowledge and technical skills with respect to preoperative, evaluation, operative management, and postoperative care of patients with critical illness.

Training will include techniques for both life-saving and diagnostic procedures, not only their performance, but the correct interpretation within the scope of the critical illness. Trainees will be competent in the interpretation of radiographic studies to include head, chest and abdominal and pelvic CT scan, abdominal ultrasound , and vascular angiographic studies. Fellows will be knowledgeable in the application of monitoring techniques applicable to surgical critical care and be aware of the indications and contra-indications to these approaches.

It is anticipated that upon completion of the fellowship in surgical critical care, that fellows will be prepared to play an active role in the socioeconomic, political climate, and unit administration that has impact on the care that they are able to provide to patients. They will also develop the presentation skills that will allow them to deliver an effective medical presentation and effective communication of complex diseases processes among other healthcare providers.

Medical Knowledge Goals

This includes knowledge of the anatomy, physiology, biochemistry, pharmacological, and clinical management of diseases that pertain to critical illness. The trainee will have a thorough understanding of the diagnosis, medical and surgical treatment of patients with critical illness.

Didactic/Teaching Objectives

The objective of the Surgical Critical Care Program is to provide additional experience for trainees whose career plan includes a major focus in critical care. The objective is for the fellow to obtain in-depth knowledge in the following aspects of critical care:

  • Cardio-pulmonary resuscitation
  • Physiology, pathophysiology, diagnosis and treatment of cardiovascular, respiratory, gastrointestinal, genitourinary, neurological, endocrine/metabolic, musculoskeletal, immune and infectious disorders
  • Metabolic, nutritional, and endocrine effects of critical care illness
  • Hematological and coagulation disorders
  • Critical obstetrical and gynecological disorders
  • Trauma, thermal, and electrical burns
  • Monitoring and invasive instrumentation
  • Critical pediatric disorders
  • Pharmacological kinetics / dynamics of drug metabolism and excretion in the ICU
  • Ethical and legal aspects of critical care
  • Principles and methods of ICU administration
  • Biostatisics and experimental design

Patient Care Goals

Competence will be attained in the evaluation and treatment of patients with critical illness. This includes knowledge regarding the molecular basis of such disease. The trainee will become familiar with the indications of adjuvant therapy and with the compliations associated with these treatments. Understanding of the role of both medical therapy and surgery in the treatment of patients with critical illness will be a major goal of the fellowship. This includes proficiency in procedures performed in patients with critical illness to include invasive hemodynamic monitoring, management of the airway, bronchoscopy, GI endoscopy, ventilator management, and other life saving procedures.

Surgical Critical Care Fellowship Experience

Individuals who complete the fellowship year(s) will be competent in the management of patients with critical illness and prepare them to independently provide care to the most injured and ill emergency general surgery and trauma patients.

Surgical Critical Care Fellowship Experience (PGY-6)

SCC Training will also include techniques for both lifesaving and diagnostic procedures not only their performance but the correct interpretation within the scope of the critical illness. Trainees will be competent in the interpretation of radiographic studies to include head, chest and abdominal and pelvic CT scan, abdominal ultrasound, and vascular angiographic studies. Fellows will be knowledgeable in the application of monitoring techniques applicable to surgical critical care and be aware of the indications and contra-indications to these approaches. It is anticipated that upon completion of the fellowship in surgical critical care, that fellows will be prepared to play an active role in the socioeconomic, political climate, and unit administration that has impact on the care that they are able to provide to patients. They will also develop the presentation skills that will allow them to deliver an effective medical presentations and effective communication of complex disease processes amongst other healthcare providers.

Surgical Critical Care (PGY-6) Rotations by Hospital
Tramua Rotation: Surgical Critical Care Unit and Burn Unit

Objectives:
To thoroughly understand the diagnosis along with the medical and surgical treatment of disorders that affect critical ill patients in the intensive care setting, and to develop technical mastery of procedures needed by critically ill patients. The fellow we also begin to gain autonomy in surgical decision-making and operative techniques.

Structure:
Under the supervision of the full-time faculty, the fellow will evaluate and treat patient with the full spectrum of critical illness. The evaluation of the patients takes place primarily in the surgical intensive care units and the burn unit of University of Louisville Hospital. Frequently, surgical patients are also housed in the MICU, CCU & Neuro ICU, allowing for additional patient exposure and experience in these areas as well. The varied patient demographic differences that are reflected in these venues provide the fellow with a rich and vast experience. In addition, they will get operative experience on call nights not covered by chief residents (Tuesdays and Fridays). This will form the bulk of trauma cases needed for the fellows on the AAST track. They will have some outpatient duties, mainly focused on burn care. Occasionally, the fellows will also help in trauma clinic when there is overflow if ICU rounds are already complete.

Elective Rotation - Burn: Burn Center

Objectives:
To thoroughly understand the diagnosis and treatment of burns, necrotizing soft tissue infections, toxic dermal necrolysis, and chronic wounds of varying etiologies. The fellows will gain knowledge on all aspects of wound care, from topical therapy to advanced surgical techniques for wound coverage. They will gain further procedural competence in normal critical care procedures including central line placement, bronchoscopy, and those specific to burns such as escharotomies. They will learn fluid replacement strategies specific to the burn population, as well as nutritional replacement, which is often so critical in any wound care scenario.

Structure:
Under the supervision of the full-time faculty, the fellow will evaluate and treat patients with the full spectrum of wounds. The evaluation of the patients takes place primarily in the emergency room and in the burn unit at the University of Louisville Hospital. They will be responsible for all aspects of burn care, from daily wound management and critical care needs, to the operative management of wound coverage. They will be responsible for covering our outpatient wound clinic on Wednesdays, in conjunction with our burn nurse practitioners. They will participate in our monthly Burn Quality Improvement Conference, and in the weekly meetings involving our burn center verification process.

Elective Rotation - Neuroanesthesia Rotation: NeuroICU

Objectives:
To thoroughly understand the diagnosis and medical treatment of disorders affecting critically ill patients in the Neuroanesthesia Unit. This includes stroke patients, isolated head injuries, and post-operative patients in ENT, OB-GYN, and Neurosurgery.

Structure:
Under the supervision of the full-time faculty, the fellow will evaluate and treat patients with a full spectrum of critical illnesses with an emphasis on the above patient population. They will become further skilled in all types of criticl care procedures, with emphasis on this rotation for airway management, as this critical care team is responsible for most inpatient airway emergencies. Furthermore, they will get more dedicated exposure to stroke management and Neurosurgical monitoring devices. The varied patient demographic differences that are reflected in these venues provide the fellow with a rich and vast experience. In addition, they will get operative experience on call nights not covered by chief residents (Tuesdays and Fridays). This will form the bulk of trauma cases needed for the fellows on the AAST track. They will have some outpatient duties, mainly focused on burn care. Occasionally, the fellows will also help in trauma clinic when there is overflow if ICU rounds are already complete.

Surgical ICU Rotation: Surgical Intensive Care Unit

Objectives:
To thoroughly understand the diagnosis along with the medical and surgical treatment of disorders that affect critical ill patients in the intensive care setting, and to develop technical mastery of procedures needed by critically ill patients.

Structure:
Under the supervision of the full-time faculty, the fellow will evaluate and treat patient with the full spectrum of critical illness. The patient population in this ICU setting will include emergency general surgery patients, vascular surgery patients, transplant surgery patients, urology patients, surgical oncology patients, and thoracic surgery patients. This will introduce an even more medically diverse patient population than what we typically care for in trauma, thereby expanding fellow education. They will perform all necessary critical care procedures to the patients. Necessary surgical interventions will be deferred to the patient’s primary surgical team.

Cardiovascular ICU Rotation: Cardiovascular Intensive Care Unit

Objectives:
To thoroughly understand the diagnosis and medical treatment of disorders affecting critically ill patients in the CVICU.

Structure:
Under the supervision of the full-time faculty, the fellow will evaluate and treat patients with a full spectrum of critical illnesses with an emphasis on post-procedure cardiac patients (CABG, VAD, and heart valves), ECMO patients, and heart and lung transplant patients. Fellows will help put patients on ECMO and run the circuits daily. They will place Swan-Ganz catheters and get dedicated echocardiography training. They will get experience with ventricular assist devices and their associated physiology. Furthermore, they will get exposure to intra-aortic balloon pump devices and associated heart failure issues which could prove life-saving in our patients with cardiogenic shock in the acute care and trauma setting.

Pulmonary Critical Care Rotation: Medical Intensive Care Unit

Objectives:
To provide critical care experience in the management of non-surgical patients in a medical ICU.

Acute Care Surgery Fellowship Experience (PGY-7)

The AAST Accredited ACS training will provide education to fellows in the care of patients, in teaching, and in research. Surgeons admitted to each fellowship are required to have completed the core training requirements of a Resident Review Committee (RRC)-approved residency in General Surgery and/or be American Board of Surgery eligible. Thus, the fellows should have already developed a satisfactory level of clinical maturity, technical skills, and surgical judgment that will enable them to begin a fellowship in the field of Acute Care Surgery. The period of training is two sequential years, and the program must comply with these requirements for fellowship training. The key components of this training include trauma surgery, surgical critical care, and complex emergency general surgery. The surgical critical care component of the fellowship must meet the requirements of an ACGME accredited Surgical Critical Care Fellowship.

Acute Care Surgery (PGY-7) Rotations by Hospital
Trauma Rotation: Surgical Critical Care Unit and Burn Unit

Objectives:
To further their understanding of trauma and acute care surgery by offering a more autonomous setting to practice.

Structure:
In the second year, the fellows will transition to leading a trauma team. The emphasis in the second year will be more geared to operative management, complex trauma cases, and management of level one activations. They will work closely with the chief residents in devising appropriate treatment strategies for complex trauma patients. They will be responsible for daily floor rounds and all trauma activations for their respective team. They will participate in all of their team’s trauma and acute care surgery cases. They will take in house trauma calls on Tuesdays and Fridays with direct attending supervision. They will also be responsible for trauma and burn clinic coverage. This year will emphasize more of a leadership role for the entire trauma team, and hopefully provide an experience of what life will be like as an attending.

Cardiothoracic Surgery Rotation

Objectives:
To understand the diagnosis, preoperative decision-making, and surgical techniques of cardiac and thoracic pathologies.

Structure:
Fellows will be a part of the cardiothoracic team, rounding and performing operations with them daily. Their main focus will be on attaining appropriate cardiac and thoracic case numbers not covered by their trauma experience to become more comfortable with exposures and operative control of hemorrhage in the mediastinum. They will be encouraged to attend clinic when not operating, to continue advancing their knowledge in cardiac physiology and echocardiography. They will also have the opportunity to travel with the cardiac and lung donor teams for organ procurement.

Vascular Surgery Rotation

Objectives:
To understand the diagnosis, preoperative decision-making, and surgical techniques associated with vascular diseases.

Structure:
Fellows will spend a month on our vascular service at M and E Hospital, which does not have resident or vascular fellowship involvement. They will attend clinic, daily rounds, and operate with the team there. The emphasis will not only be on operative exposures required for AAST cases, but also endovascular techniques, which will improve the fellow’s ability to perform on table angiography and gain vascular access safely.

Acute Care Surgery Rotation: Surgical Critical Care Unit and Burn Unit

Objectives:
To diagnose and treat a wide range of surgical pathologies in the acute care setting. Indirect supervision will be provided to allow appropriate autonomy.

Structure:
Fellows will spend the latter months of their final year gaining necessary autonomous practice with indirect supervision. They will help staff our ACS service, taking call and performing weekly rounding duties. They will also have their own surgery clinic, to help maintain patient continuity for postop care. They will not graduate to this until approved by the program director as explained in our supervision policy. Back-up call will always be available. In addition, fellows will have the opportunity to be involved in donor call, where they will travel with the transplant team for organ procurement.

Surgical Critical Care Fellowship
Stipend Amounts (2022-2023)
POST GRADUATE LEVEL ANNUAL MONTHLY
Post Graduate Level 1 $57,755.46 $4,812.96
Post Graduate Level 2 $59,913.83 $4,992.82
Post Graduate Level 3 $61,848.34 $5,154.03
Post Graduate Level 4 $64,642.39 $5,386.87
Post Graduate Level 5 $67,775.42 $5,647.95
Post Graduate Level 6 $70,834.52 $5,902.88
Post Graduate Level 7 $73,781.68 $6,148.47
Post Graduate Level 8 $77,703.51 $6,475.29
Stipend rates based on 2% increase for all PG levels.
Practice liability insurance

Malpractice coverage is provided by U of L, VAMC, and/or private affiliated hospitals under terms of your contract.

Medical/Hospitalization Insurance

Single and family coverage is available to all residents and begins the first day of the academic year.

Life and Accident Insurance

Each fellow receives, free of charge, life insurance for the value of twice the annual salary. Workers' compensation, accidental death and dismemberment insurance are also provided.

Private, fully furnished, office space.

Discounts on U of L athletic events/season tickets.

Use of:
  • U of L Swimming Pools
  • Fitness Centers
  • Bass Rudd Tennis Center

Surgical Critical Care Fellowship Application & Interview Process

Application Procedure

Applications must be submitted using SAFAS at https://safas.smapply.io/.
Applications are accepted March 1 – May 1 of each year. We strongly encourage early application.

A completed application consists of the following:

  • Application / CV
  • USMLE Scores
  • 3 letters of Recommendation
  • Current Photo
  • Personal Statement
Contact

Samantha Oliver, Fellowship Coordinator
Email: Sngear01@louisville.edu
Phone: 502-852-6191

Interview Process

The Surgical Critical Care Program in Department of Surgery at the University of Louisville participates in the National Residency Matching Program (NRMP) developed by the Association of American Medical Colleges in the recruitment of all extramural fellows.

Candidates are required to have completed 5-years of General Surgery training in an ACGME accredited program, and must be American Board of Surgery eligible.

The Surgical Critical Care Review Committee will screen all applicants based on their accomplishments, and invitations will be issued via email. Upon receipt of the invitation, please contact Samantha Oliver, Fellowship Coordinator via the email sent to arrange your interview according to the following schedule.

  • Interview Dates
  • April 25, 2023
  • May 9, 2023
  • May 23, 2023
  • June 6, 2023

Interviews will be conducted virtually and typically begin at 8:30am EST.

Dr. Nicholas Nash, Program Director, will give an overview of the program. Candidates will then have half-hour interviews with trauma faculty as well as an opportunity to communicate with current fellows about individual questions regarding the program.

A ranking meeting is held each June - July. Each applicant's folder is thoroughly reviewed and discussed by the faculty. Applicants are ranked in the order agreed upon by the faculty. After the rank order list is generated, it is entered electronically and submitted to the NRMP by the August deadline.

Surgical Critical Care Fellows
Erin Fuller, M.D. David Keeven, M.D.
Erin Fuller, M.D.
Rhode Island Hospital/Brown University
Providence, Rhode Island
David Keeven, M.D.
University of Louisville
Louisville, Kentucky
Tyler Van De Voort, M.D.
Tyler Van De Voort, M.D.
University of North Dakota
Grand Forks, North Dakota
Surgical Critical Care Faculty

Please click on a physician's name to view their information.

Nicholas Nash, M.D.
Nicholas Nash, M.D., Program Director,
Surgical Critical Care Fellowship
Jason W. Smith, M.D.
Jason W. Smith, M.D., Ph.D.
Berel L. Abrams, M.D. Chair in Surgery
at University of Louisville Department of Surgery
Director, Division of General Surgery
Associate Program Director, Surgical Critical Care Fellowship
Matthew V. Benns, M.D. Matthew C. Bozeman, M.D.
Matthew V. Benns, M.D. Matthew C. Bozeman M.D.
William G. Cheadle, M.D. Jamie Coleman, M.D.
William G. Cheadle, M.D. Jamie Coleman, M.D.
Glen A. Franklin, M.D. Brian G. Harbrecht, M.D.
Glen A. Franklin, M.D. Brian G. Harbrecht, M.D.
Hiram C. Polk Jr., M.D Chair in Surgery
George Marshall, M.D. Kieth R. Miller, M.D.
George “Ryne” Marshall, M.D. Kieth R. Miller, M.D.
Samuel Pera, M.D.
Samuel Pera, M.D.
Surgical Critical Care Fellowship
Alumni (1996–2022)
FIRST NAME LAST NAME START DATE END DATE
Amanda Chelednik 8/1/2021 7/31/2022
Ibraheem Kayali 8/1/2021 7/31/2022
Branden Kret 8/1/2020 7/31/2021
Samuel Pera 8/1/2020 7/31/2021
George "Ryne" Marshall 8/1/2019 7/31/2020
Lindsay Arnold 8/1/2019 7/31/2020
Frank Wood 8/1/2018 7/31/2019
Kathleen Hromatka 8/1/2018 7/31/2019
Amirreza Motameni 8/1/2017 7/31/2018
Johnson Walker 8/1/2017 7/31/2018
Brian Strollo 8/1/2016 7/31/2017
Nathan Ludwig 7/1/2016 6/30/2017
Terry McKinney 9/1/2015 8/31/2016
Nicole Garcia 7/1/2015 6/30/2016
Joseph Karam 7/1/2014 6/30/2015
Charles Kimbrough 7/1/2014 6/30/2015
Abindra Sigdel 7/1/2014 6/30/2015
Michael Mackowski 7/1/2013 6/30/2014
Crystal Pressley 7/1/2013 6/30/2014
Matthew Bozeman 7/1/2011 6/30/2012
Katie Love 7/1/2011 6/30/2012
Dustin Neel 7/1/2010 6/30/2011
Greg Huang 7/1/2010 6/30/2011
Keith Miller 7/1/2009 6/30/2010
Debra VanZandt 7/1/2008 6/30/2009
Maya Leggett 7/1/2008 6/30/2009
Patrick Klapheke 7/1/2007 6/30/2008
Ariel Santos 1/1/2007 12/31/2007
Matthew Kozloff 7/1/2006 6/30/2007
Aaron Brown 7/1/2006 6/30/2007
Steven Casos 7/1/2005 6/30/2006
Eric Satterfield 7/1/2004 6/30/2005
Benjamin Manning 7/1/2004 6/30/2005
Ashley Wilson 7/1/2003 6/30/2005
Britton Christmas 7/1/2003 6/30/2004
Jason Hoth 7/1/2001 6/30/2003
James Lukan 7/1/2000 6/30/2001
Nichole Stassen 7/1/2000 6/30/2002
Glen Franklin 7/1/1998 6/30/2000
Christopher Wohltmann 7/1/1997 6/30/1999
Robert Schmieg 7/1/1996 6/30/1998
Surgical Critical Care Fellowship Contact Information

For additional information or assistance with applications, please contact:

Samantha Oliver, Surgical Critical Care Fellowship Coordinator
University of Louisville
Department of Surgery
550 South Jackson Street
Louisville, Kentucky 40202
(502) 852-6191
sngear01@louisville.edu

Or Dr. Nick Nash, Fellowship Program Director
University of Louisville
Department of Surgery
550 South Jackson Street
Louisville, KY 40202
(502) 852-6191
nanash01@louisville.edu

Or Dr. Jason Smith, Associate Fellowship Program Director
University of Louisville
Department of Surgery
550 South Jackson Street
Louisville, KY 40202
(502) 562-5619
jasonw.smith@louisville.edu