Can We augment the US Trauma Fellow's Operative Training? The PTS Fellowship: A US Surgical Critical Care Fellow's Experience in Colombia

Abstract

Objective: To send an American fellow surgeon to a Panamerican country and quantify operative skills acquisition. Materials and methods:A second year surgical critical care fellow from a Level One Urban Trauma Center was sent to Cali, Colombia from April 1 to 21, 2013. The operative experience was evaluated. Total cases, first time cases, and first time procedures, defined as technical portions within trauma cases, were recorded. Results:In 20 operative days, 172 total cases were performed in the following categories: burn 112, trauma 19, emergent general 16, elective general 14, plastics 8, and laparoscopic bariatric 3. First exposure operations included 46/112 burn cases, 8/8 trauma/burn reconstructive cases, 1/16 emergent general cases, 11/14 elective general cases, and 3/3 laparoscopic bariatric cases. Of the 19 total trauma operations (not including 2 amputations), 3 left anterolateral thoracotomies, 2 clamshell thoracotomies, 1 diagnostic laparoscopy, 1 open pericardial window, 10 exploratory laparotomies and 2 relaparotomies were performed. The 19 trauma operations consisted of 26 (not including the 2 amputations) procedures. Twenty-three percent were first time performed trauma procedures (6/26, not including amputations).Nearly 9 (8.6) operations were performed per day. In five 12-hour shifts of trauma call, 19 operations were performed within 60 hours. One trauma operative case was performed for every 3.15 hours worked. Conclusion:In the current era of American trauma training in which penetrating trauma and total number of operative cases is concentrated to specific centers in the United States, additional methods in education and experience should be sought for the American trauma fellow. This is the first reported international trauma fellow rotation in Cali, Colombia, with an operative experience very different than standard and current opportunities. Our experience serves as a potential template for future endeavors in surgical education. Conclusión: En la era actual de la formación trauma estadounidense en la que el trauma penetrante y el número total de casos quirúrgicos se concentra a centros específicos en los Estados Unidos, los métodos adicionales en la educación y la experiencia debe buscarse la American Trauma Fellow. Este es el primer informe de compañero de trauma rotación internacional en Cali Colombia, con una experiencia operativa muy diferente a la estándar y oportunidades actuales. Nuestra experiencia sirve como plantilla potencial para futuros esfuerzos en la educación quirúrgica.Palabras claves: Communion trauma panaerica, Communion operative internacional, Rotacion trauma.