BOSTON MEDICAL CENTER
RESIDENCY IN SURGICAL CRITICAL CARE
GOALS AND OBJECTIVES
RESIDENT IN SURGICAL CRITICAL CARE
EDUCATIONAL GOALS AND OBJECTIVES
- Learn the comprehensive clinical approach to patients with critical illness
- Gain advanced expertise in complex surgical and medical problems in critically ill surgical patients
- Learn how to manage a critical care unit
- Appreciate and contribute to research in critical care medicine
- Learn how to develop and administer an educational program in critical care medicine
- Learn how to become a cost effective critical care physician
- Instruction of Critical Care Residents and General Surgery Residents in the art and science of Critical Care Medicine
- Evaluate the Critical Care Program and Critical Care Faculty in writing near the completion of the Critical Care Fellowship
- Take the Critical Care In-Service Examination
- Attend and be an active participant in all critical care educational meetings, conferences, and presentations.
- Attend the following general surgery conferences: weekly Mortality and Morbidity Conference, Surgical Grand Rounds, Core Curriculum Conference, Chief’s Walk Rounds, Vascular Conference, Oncology Conference, and ICU Walk Rounds
- Initiate and continue a critical care reading program
- Maintain ACLS/ATLS certification. Teach advanced cardiac life support
- Maintain a procedure book to include: intubation, pulmonary artery catheters, central venous catheters, line changes, chest tubes, bronchoscopy, peritoneal lavage, arterial lines, thoracentesis, paracentesis, cardiac pacing, and other procedures
- Supervise house staff in the assigned SICU, including patient care decisions/procedures.
- In conjunction with the critical care attending, supervise/perform all the procedures performed in the SICU
- Preoperatively, consult on all patients likely to require the SICU postoperatively
- Supervise all critical care consults. Review all preoperative consults performed by medical students and general surgery residents, including assessments and plans.
- Teach residents the appropriate requirements for medical documentation
- Supervise the critical care house staff and medical students. This includes responsibility for daily patient bedside rounds and implementation of the patient care plan and direct supervision of all SICU procedures.
2.
ADMINISTRATIVE GOALS AND OBJECTIVES
- Help maintain the ICU Registry/Complication Book
- Attend the following meetings: Critical Care Committee, Ethics Committee, Patient Care Rounds, Collaborative Practice Committee
- Coordination with the Nurse Manager of the SICU with regard to patient flow in an out of the SICU
- Participate in writing protocols for the SICU
- Participate in the weekly Patient Care Conference
- Provide as needed in-services to Nursing, Pharmacy, Respiratory, and Physical Therapy
- Communicate all admissions, discharges, changes in condition, and need for invasive procedures to the Critical Care attending and ensure that the operating service is kept informed
- Round twice daily, Monday through Friday, and daily rounds on weekends
- Provide administrative leadership in the SICU and progressive care units including development of the collaborative practice model, total quality management, and leadership in ethical, economic, and other aspects of critical care
- Implement the daily patient care plan that is agreed upon between the surgical team and the critical care team
- Documentation must include the following:
- Consultations – all patients
- Comprehensive daily note – all patients – must be dated and timed
- Interval note – any significant change must be timed
- Procedure note – brief, for any procedure including line removals
- Transfer note
- Dictation of deaths and transfers to another institution