Acute Care Surgery Fellowship at ZSFG/UCSF

The AAST approved Acute Care Surgery Fellowship at ZSFG/UCSF is a 12-month, non-ACGME, structured fellowship designed to equip a Board-Eligible or certified general surgeon who has completed training in Surgical Critical Care with the clinical and administrative skills necessary to assume a leadership role in Trauma/Acute Care Surgery. 

The Department of Surgery at ZSFG accepts two (2) new fellows into the Acute Care Surgery Fellowship at ZSFG/UCSF Fellowship each year, following completion of the corresponding ACGME approved fellowship in Surgical Critical Care at ZSFG.

The fellowship is divided into two major components. The first component (first 8 months of the fellowship) includes 12 weeks of Trauma/Acute Care Surgery rotations, Trauma/Acute Care Surgery call, and required elective rotations. These are intended to give the fellows the necessary clinical expertise, professional development, and teaching instruction to function in the role of an academic attending over the second component of their fellowship (final 4 months). 

The ACS Fellow is appointed as a Clinical Instructor with UCSF, is an active member of the medical staff at ZSFG and participates in Department of Surgery meetings and conferences. The fellow has oversight responsibilities for the care of Trauma/Acute Care Surgery patients at ZSFG. In addition to participating in the care of the most complex surgical patients on the Trauma/Acute Care Surgery Service, the fellow is expected to engage in new or ongoing programs in performance improvement, clinical research, injury prevention, and trauma systems development.

Structure Of the Fellowship

Clinical Rotations: 

Core ACS Rotation (22 weeks)

• Trauma/Acute Care Surgery at ZSFG (Final 10 weeks in an Attending clinical instructor role)

The Acute Care Surgery Fellows spend the entirety of their clinical ACS experience at the Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG).  The rotation is constructed in 2-week blocks alternating with the other ACS Fellow. Fellows spend 2 weeks on the Trauma/ACS Service at ZSFG (Mon-Friday) followed by 2 weeks off service.  During off service weeks fellows are involved in research, teaching, and required experiential or elective rotations. First year Surgical Critical Care Fellows spend 2 months on the Trauma/ACS service which affords additional elective and research time to the ACS fellow.

Required Experiential Rotations 

• Vascular Surgery (1-2 days per off service week; Minimum 8 days)
• Cardiac Surgery (1-2 days per off service week; Minimum 8 days)
• Hepato/Renal and Cardiac Procurement (1-2 procurements per month; minimum 6)
• Trauma / EGS Multidisciplinary Outpatient Clinic (1 day per week)

Required Elective Rotations:

• Critical Care Echocardiography (2-4 weeks)
• Trauma Anesthesia (2 weeks)

Available Electives 

• Pediatric Trauma at Oakland Children's Hospital
• Neurosurgery
• Orthopedic Surgery
• Other available upon request 

During off service weeks/months fellows participate in experiential rotations.  Depending on the available cases they may choose to participate in either Vascular (ZSFG) or Cardiac Surgery Procedures (UCSF-Moffit Long), and / or sign up for Organ Procurement Call.  Additionally, the fellow participates in a weekly Trauma / EGS Multidisciplinary follow up clinic that includes our Violence Intervention Professionals  (Wraparound Project) and Trauma Mental Health Specialists (Trauma Recovery Center).  Fellows also spend 2 dedicated weeks learning Critical Care Echocardiography and Trauma Anesthesia (focus on airway management and endotracheal intubation)

Education:

• ACS Didactic Curriculum (weekly)
• Trauma EGS Challenging Cases Faculty Fellow Case Conference (Monthly)
• ACS Journal Club (Monthly)
• AAST Meet the Mentors
• AAST Virtual Grand Rounds

Acute Care Surgery fellows at ZSFG enjoy a varied comprehensive educational experience. In addition to dedicated protected time to participate in AAST, ACS fellow educational offerings, fellows participate in multiple weekly fellow dedicated conferences that include a dedicated Acute Care Surgery didactic curriculum, a Trauma/EGS faculty fellow case conference, Work in Progress (Research) Conference, and ACS Critical Care Journal Club. Additionally, the fellows participate in the Department of Surgery ZSFG quality assurance conferences (Morbidity & Mortality, Peer Review, Video Case Conference), and in residents Acute Care Surgery conferences.

Research / Professional Development:

• Work in Progress (Research) Meeting (Monthly)
• Trauma Performance Improvement Meeting (Weekly)
• Multidisciplinary Peer Review (Monthly)

UCSF is dedicated to the professional and career development of ACS fellows with the intent of them contributing as future leaders in Academic Surgery. Fellows participate in research projects and activity with support from individual faculty members and from the Division through monthly research meetings. In addition to divisional opportunities, fellows may participate in Departmental research through several collaborative opportunities including in global health, surgical education, and Health Equity (CHESA,  Surgical Education Research, C-Shore).  Additionally, fellows actively participate in the Trauma Performance Improvement and Patient Safety Quality Assurance process through weekly meetings with the Trauma Medical Director and core PI team as well as actively participating in the Multidisciplinary Peer Review Process.