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

Abstract

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. How to cite this article Peck GL, Paula F, Joseph H, Ferrada R, Christopher D, Ordonez C, Aboutanos M, Gracias V. Can We augment the US Trauma Fellow's Operative Training? The PTS Fellowship: A US Surgical Critical Care Fellow's Experience in Colombia. Panam J Trauma Crit Care Emerg Surg 2014;3(1):1-7.