UNIVERSITY OF MINNESOTA
GRADUATE MEDICAL EDUCATION
2011-2012
FELLOWSHIP
POLICY & PROCEDURE
ADDENDUM
Department of Surgery
Surgical Critical Care
Fellowship Program
Websites: www.med.umn.edu/gme/central
www.surg.umn.edu
www.surg.umn.edu/surgery/Divisions/SICU/home.html
Orig. 5/9/11
Confirmation of Receipt of your Fellowship Addendum for Academic Year 2011-2012
By signing this document you are confirming that you have received and reviewed your Fellowship Addendum for this
academic year. This policy manual contains policies and procedures pertinent to your training program. This receipt will
be kept in your personnel file.
Fellow Name (Please print) _______________________________________________
Fellow Signature ________________________________________________________
Date __________________
Coordinator Initials ________________
Date __________________
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Table of Contents
INTRODUCTION
 Introduction ......................................................................................................................................6
 Department of Surgery Mission Statement ......................................................................................7
 Surgical Critical Care Fellowship Program Mission Statement ......................................................7
SECTION 1. STUDENT SERVICES
 (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
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Medical School Policies on the following: Academic Health Center (AHC) Portal Access; Child Care; Computer
Discount/University Bookstore; Credit Union; Disability Accommodations; Legal Services; Library Services; Medical
School Campus Maps; Nursing Mothers Resources; Resident Assistance Program; University Card (UCard);
University Events Box Office; University Recreation Sports Center(s))
Universal University Pagers ............................................................................................................8
Email and Internet Access ...............................................................................................................8
University Mailboxes and Campus Mail .........................................................................................9
Laboratory Coats ..............................................................................................................................9
UMMC-F Photo ID Badge...............................................................................................................9
HIPAA Privacy Regulations ............................................................................................................9
SECTION 2. BENEFITS
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Insurance: Dental Insurance; Health Insurance; Life Insurance; Voluntary Life
Insurance; Long-Term Disability; Short-Term Disability; Insurance Coverage Changes; Immunization Services; Exercise
Room at UMMC-FV; Bereavement Leave; Family Medical Leave Act (FMLA); Holidays; Medical Leave; Military Leave;
Parental Leave; Personal Leave; Professional Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for
Satisfying Completion of Program; Loan Deferment; Loan Program: Emergency Loan Program through Minnesota
Medical Foundation; Minnesota Medical Association Membership; Professional Liability Insurance; Stipends; Veterans
Certification for Education Benefits; Workers’ Compensation Benefits).
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Stipends ................................................................................................................................... 10
Health and Dental Insurance Coverage....................................................................................10
Long Term Disability Insurance ..............................................................................................11
Short Term Disability Insurance ..............................................................................................11
Professional Liability Insurance ..............................................................................................11
Life Insurance ..........................................................................................................................11
Meal Tickets.............................................................................................................................11
Parking .....................................................................................................................................11
Policy on Effect of Leave for Satisfying Completion of Program...........................................12
Vacation Policy ........................................................................................................................12
 Professional and Academic Leave .....................................................................................12
 Parental Leave ....................................................................................................................12
 Sick Leave Policy ..............................................................................................................12
SECTION 3 - INSTITUTION RESPONSIBILITIES
 (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation
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Services; Master Affiliation Agreements or Institution Affiliation Agreements; Program Letters of Agreement;
Confirmation of Receipt of Program Policy Manuals; Designated Institution Official Designee Policy; Duty Hour
Monitoring at the Institution Level Policy and Procedure; Experimentation and Innovation Policy; Funding; GME
Competency Teaching Resources and Core Curriculum; Graduate Medical Education Committee (GMEC)
Responsibilities; Graduate Medical Education Committee Resident Leadership Council Responsibilities; Institution
and Program Requirements; Internal Review Process; International Medical Graduates Policy; New Program
Process; Orientation; Visa Sponsorship Policy). ...................................................................................... 13
SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student
Academic Complaints; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination
Reporting; Sexual Assault Victim’s Rights Policy; Dispute Resolution Policy)
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SECTION 5 - GENERAL POLICIES AND PROCEDURES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Academic Health Center (AHC) Student Background Study Policy; Background
Study Policy and Procedure; Academic Incivility: Resources for Dealing with Harassment; Applicant Privacy Policy;
Appointment Letter Policy and Procedure; Blood Borne Pathogen Exposure Policy; Certificate of Completion Policy;
Classification and Appointment Policy; Compact for Teaching and Learning; Disability Policy; Disaster and Local
Extreme Emergent Situation Planning Policy and Procedure; Documentation Management Requirements Policy; Dress
Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours/Prioritization of On-Call Room
Assignments; ECFMG/J1 Visa Holders: Documentation Required for FMLA; Effective Date for Stipends and Benefits
Policy; Eligibility and Selection Policy; Essential Capacities for Matriculation, Promotion and Graduation for U of M
GME Programs; Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and
Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and Procedure; Licensure
Policy: Life Support Certification Policy; Moonlighting Policy; National Provider Identification (NPI) Policy and
Procedure; National Residency Matching Program (NRMP) Fees Policy; Nepotism Policy; Observer Policy; Post Call
Cab Voucher Policy (UMMC-F; HCMC); Registered Same Sex Domestic Partner Policy; Release of Contact Information
for Solicitation Purposes Policy; Residency and Fellowship Agreement Policy and Procedure; Residency Management
Suite (RMS): Information Maintenance for Participating Hospitals; Residency Management Suite (RMS): Updating and
Approving Assignments and Hours in the Duty Hours Module of RMS; Restrictive Covenants; Social Networking Policy;
Standing and Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy; Supervision
Policy; Trainee File and Document Retention Policy; Training Program and/or Institution Closure or Reduction Policy;
Transitional Year Policy; USMLE Step 3 Policy; Vendor and Conflict of Interest Policy; Verification of Training and
Summary for Credentialing Policy; Without Salary Appointment Policy ).
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Program Goals and Objectives.................................................................................................14
Training and Graduation .................................………………………………………………14
Residency Program Curriculum ...............................................................................................15
ACGME Competencies ...........................................................................................................16
Duty Hours Policy....................................................................................................................19
Resident Duty Hours and the Working Environment ..............................................................19
On-Call Schedules ...................................................................................................................21
Resident Supervision Policy ....................................................................................................21
Graded Responsibility..............................................................................................................24
Support Services (Facilities & Resources) ..............................................................................24
UMMC On Call Rooms ...........................................................................................................25
UMMC Resident Lounge .........................................................................................................25
Laboratory/Pathology/Radiology Services ..............................................................................25
Medical Records ......................................................................................................................26
Security/Safety .........................................................................................................................26
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Monitoring of Resident Well-Being ........................................................................................26
Communication Policy.............................................................................................................27
Grand Rounds Compliance ......................................................................................................27
Dress Code Policy ....................................................................................................................27
Moonlighting............................................................................................................................28
American Board of Surgery - Requirements for Certification in Surgery ...............................28
Evaluations and RMS ..............................................................................................................29
Patient Log ...............................................................................................................................29
Resident Rotation Dates ...........................................................................................................31
SECTION 6 - ADMINSTRATION
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: GME Administration Contact List, GME Administration by Job Duty; GME
Organization Chart)
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Administrative Contact List ...........................................................................................................31
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Introduction
This Fellowship Addendum refers to policies and procedures specific to your training
program. Please refer to the Institution Manual and the Program Policy Manual for your
Department for further policies and procedures on the following: Student Services;
Benefits; Disciplinary and Grievance Procedures; General Policies and Procedures;
Administration.
For information that applies to all residency/fellowship training programs at the
University of Minnesota, please consult the Institution Manual. Information in the
Institution Manual takes precedence over that in the Program Manual and Fellowship
Addendum, in cases where there is conflict.
All manuals are available online:
Institution Manual: http://www.med.umn.edu/gme
Program Manual & Addendum: www.surg.umn.edu/surgery/Divisions/SICU/home.html
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Department of Surgery Mission Statement
The mission of the Department of Surgery is teaching, research, and provision of excellent
clinical service. The primary academic mission is to teach medical students, residents and
fellows, and advanced degree candidates with the focus of developing academic surgeons
and advancing knowledge in surgical specialties through scientific and clinical research
endeavors.
Surgical Critical Care Fellowship Program Mission Statement
 Provide high quality, humane care to critically-ill surgical patients.
 Provide a high quality educational experience for residents and medical
students in the care of the critically-ill surgical patient.
 Continue the tradition of excellence in the training and continuing
education of physicians with a special interest in critical care.
 Provide an environment for performance of high quality research designed
to improve our understanding of the pathophysiology of the critically-ill
surgical patient and the treatment and care of this patient population.
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SECTION 1 - STUDENT SERVICES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Academic Health Center (AHC) Portal Access; Child Care; Computer
Discount/University Bookstore; Credit Union; Disability Accommodations; Legal Services; Library Services; Medical
School Campus Maps; Nursing Mothers Resources; Resident Assistance Program; University Card (UCard); University
Events Box Office; University Recreation Sports Center(s)
Universal University Pagers
Your UMMC-F pager assigned to you remains the same for the duration of your training. Do not turn it
in when you rotate off site. For malfunctioning pagers please contact Debbie in the Surgical Critical Care
Office or during off hours go to the UMMC-Fairview main Information Desk for assistance. New batteries can
be obtained from the Surgical Critical Care Office, 11-115 PWB Bldg.
E-mail and Internet Access
To set up e-mail account:
Check to make sure you are registered as a student (all surgical residents are registered students at the
University of Minnesota). You can do this by going to the U of MN-Twin Cities home page at
http://www1.umn.edu/twincities/. Click on Search icon. Under search for people, type in your name and
click on search. If you are not registered, you won’t be in the system. If you are not registered, please contact
the Surgical Education Office at 612-625-3926 to make sure all of your paperwork is complete.
Call the e-mail helpline at 612-301-4357, or go to the Computer Information Services Office in Room
152 Shepherd Laboratories, 100 Union Street, to set up your account and password.
To access your e-mail account:
Any computer with Internet access can be used to access your email. (See below for setting up
access from home.)
Go to http://www.mail.umn.edu/ (if you forget this address, there is a link to this page on the
Department of Surgery home page at http://www.surg.umn.edu ).
Click on Check your e-mail via your Web browser.
Enter your X500 ID, NOT YOUR EMAIL ADDRESS.
Ex: If your e-mail address is smith999@ umn.edu, your X500 ID is smith999.
Enter your password.
Click on Login.
To set up Internet access from home:
- Faculty, staff, and students at the University of Minnesota can purchase internet kits from any of
the three walk-in locations of the Academic & Distributed Computer Services: 152 Shepherd Labs
(East Bank), 93 Blegen Hall (West Bank), or 50 Coffey Hall (St. Paul), or from the Bookstore
Computer Store in Coffman Memorial Union.
- You will need to bring a photo ID with you, preferably your U Card.
- The cost of the kits is $6.00, and they accept cash or checks only.
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- The kits are available on CD.
- The Internet kit on CD contains software and installers for Windows 95/98/NT4, Windows 2000,
XP and Macintosh, as well as other useful programs and utilities.
More information about the internet kits can be found at http://www1.umn.edu/adcs/help/kits.html
University Mailboxes and Campus Mail
Mailboxes have been assigned to you. They are located in the Fellows cubicle in 11-115 PWB. It is
essential that you pick up your mail at least weekly. These boxes are not locked. Your campus mail address is
420 Delaware St. SE, MMC 11, Minneapolis, MN 55455.
Laboratory Coats and Laundry Service
Lab coats can be purchased through the University of Minnesota Bookstore, located in Coffman
Memorial Union, or from an outside agency. Be sure to have your name and department stitched over the
breast pocket if coats will be laundered by the hospital. Soiled coats can be dropped off in the hamper near the
Surgery Department on the 11th floor PWB, not in the hospital. Christine Vincent has the key to the closet.
Clean coats may be picked up one to two weeks later from the Labcoat Closet. To comply with Fairview
requirements, lab coats should not contain any other institution name.
UMMC-F Photo ID Badge
You can obtain a UMMC-F photo ID badge on either the Riverside campus or the University campus.
To obtain a badge on the Riverside campus go to the Main Security Office, M141 East Building. They are open
24 hours a day, 7 days a week. To get there, board the Fairview shuttle to the Riverside campus--you may
obtain the schedule from the UMMC-F Information Desk. The shuttle drops you off at the East Building. Go
in the entrance and follow the signs to the Main Security Office. The office will have a list of Department of
Surgery residents. You will be required to fill out a form giving your name, address, Social Security Number,
etc. On the University campus, go to B-340 Mayo. They are open Thursdays from 12:00 PM to 5:00 PM and
Fridays from 7:00 AM to 12:00 PM. You must have either a driver’s license or state ID AND a resident
verification form. You will receive your badge right away if you go to the Riverside campus. If you go to the
University campus, it will be sent to you. For further information, call 612-672-4544.
HIPAA Privacy Regulations
In order to be in compliance with HIPAA privacy regulations, every University of Minnesota student,
faculty member, researcher, and staff person are required to complete at least four on-line courses about privacy
and data security.
To access training, log on to http://www.myu.umn.edu . Everyone will need to complete the following
three courses:
The Video Awareness course
The Privacy and Confidentiality in the Clinical Setting course
The Privacy and Confidentiality in Research course
Accessing the Online HIPAA Courses
1. Go to http://www.myu.umn.edu
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2. Select “Click here to Sign-in”, located in the upper left hand corner of the portal homepage.
3. Authenticate using your U of M Internet ID and password.
4. Confirm that authentication was successful by looking for the “Signed in as (your name)” in the
upper left hand corner where you selected “Click here to Sign-in”.
5. Select my Toolkit.
6. Go to the section titled “(Your Name) Projects To Do lists”.
7. Look for the title of the training course that you need to complete. Select the course and a new
window will open up. You can begin taking the course.
8. After you complete the course, close the window to return to your To Do list. You can then
proceed with the next course or if you are finished, you can log out of the portal.
9. If you have to quit the training in the middle of a course that is in WebCT, you can go back into
the course and select the “Resume Course” button in the upper navigation to get back to the
page you were on.
10. You will receive an email confirming your completion of the course. Print out the confirmation
for your records. Your completion of the courses will be tracked electronically.
11. Please remember to LOG OUT of the portal when you are finished. If you leave the computer
while you are logged in, others could use your log in to access your private information such as
HR information
SECTION 2 - BENEFITS
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Insurance: Dental Insurance; Health Insurance; Life Insurance; Voluntary Life
Insurance; Long-Term Disability; Short-Term Disability; Insurance Coverage Changes; Immunization Services; Exercise
Room at UMMC-FV; Bereavement Leave; Family Medical Leave Act (FMLA); Holidays; Medical Leave; Military Leave;
Parental Leave; Personal Leave; Professional Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for
Satisfying Completion of Program; Loan Deferment; Loan Program: Emergency Loan Program through Minnesota
Medical Foundation; Minnesota Medical Association Membership; Professional Liability Insurance; Stipends; Veterans
Certification for Education Benefits; Workers’ Compensation Benefits).
Stipends
Resident/fellows will be paid a yearly stipend as stated in the offer letter and in the Program Manual.
Residents/fellows will receive a paycheck biweekly. Residents/fellows are encouraged to use the direct-deposit
system, as paychecks have the potential of being lost or delayed in the mail.
University of Minnesota Medical School, Graduate Medical Education
2011-2012 Base Stipend Rates
Level: G6 Annual Base Stipend: $57,620
The University of Minnesota payroll is a 10-day delayed start system, paid every 2 weeks.
Health and Dental Insurance Coverage
See the Institution Manual. Benefits are handled by the Office of Student Health Benefits. Their website is
http://www.shb.umn.edu . They can be reached at 624-0627.
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Long Term Disability Insurance
See the Institution Manual. Benefits are handled by the Office of Student Health Benefits. Their website is
http://www.shb.umn.edu . They can be reached at 624-0627.
Short Term Disability Insurance
Short Term disability insurance is offered as an optional coverage. The cost is based on the amount of
coverage elected. Coverage may be applied to in increments of $100 from a minimum of $300 to a maximum
of $5000, but not to exceed 2/3 of the fellow’s monthly gross salary. Benefits are effective the first day of a
disability due to an accident or the eighth day of disability due to sickness or pregnancy and, if certified, can
continue for up to 26 weeks.
Professional Liability Insurance
See the Institution Manual for information. The web address is
http://www.med.umn.edu/gme/residents/instpolicyman/home.html for contact information..
Life Insurance
See the Institution Manual. Benefits are handled by the Office of Student Health Benefits. Their website is
http://www.shb.umn.edu . They can be reached at 624-0627.
Meal Tickets
Meal Tickets will be provided for you on all regular rotations (excludes elective rotations). Meal tickets
are electronic in the UMMC and Riverside cafeteria and can be obtained from Debbie in the critical care
administrative office 11-115b; at the VA, the kitchen has a list of who is on call; and at Regions, the Surgical
Education Office will provide you with preprogrammed meal cards. At all other sites, the on-site Education
Office will provide you with the details of your meal allowances.
Parking
Paid parking is provided to fellows while they are officially rotating at the site. Paid parking may or may
not be available while participating in an elective rotation at the U. Fellows rotating at the University of
Minnesota site are provided with a parking card for the Oak St. ramp to use during their rotation. The card
must be turned in to Debbie or Colleen in the administrative office on the last day of the University SICU
rotation so it is available for the next fellow.
There are two options for parking at the V.A. Medical Center. There is an open employee lot and a gated
physician parking area. The VA ID badge allows access to parking in the gated lot.
At Regions Hospital, ID badges are obtained the first day of rotation. The badge allows free parking in
the ramp or open lot and can be retained for the duration of the fellowship year. The Regions’ badge should be
turned in to Debbie in 11-115b PWB Bldg. on the last day in the fellowship program.
At HCMC, fellows should contact Phyllis Squiers to obtain a parking pass for the hospital ramp at the
corner of 8th and Chicago.
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At NMMC, free parking is provided to fellows in the Oakdale Parking Ramp (off Hwy 81 and Abbott).
When not on service at UMMC, parking is provided for you in the Washington Avenue Ramp when
attending SICU Journal Clubs and Quarterly Educational Meetings.
Policy on effect of Leave for Satisfying Program Requirements
ACGME requirements state that an accredited surgical critical care program shall be 12 months, of which two
months may be elective rotations. Any leave that results in an educational experience of less will need to be extended in
order to successfully complete the program and be eligible to take the exam for Added Qualifications in Critical Care.
Vacation Requests
Three weeks of vacation per year are allowed for fellows. Fellows must complete an “SICU Fellow Vacation
Request” form which can be obtained from the Critical Care website www.surgery.umn.edu/Divisions/SCC and receive
approval from the Site Director at the location they are rotating at and the Director of the Program. Every effort will be
made to accommodate reasonable requests. Vacations are discouraged during the last two weeks of the fellowship.
Professional and Academic Leave
Fellows are required to attend the Society of Critical Care Medicine’s annual meeting. Currently, funding is
provided for reasonable travel related expenses. Please contact Debbie in 11-115b PWB Bldg. for assistance in making
travel arrangements and completing the necessary paperwork. Funded travel for other meetings is on a per case basis and
at the discretion of the Fellowship Director.
Family Medical Leave Policy/Childbirth or Adoption
A leave of absence for serious illness of the resident/fellow, serious health condition of a spouse, parent,
or child, or birth or adoption of a child, shall be granted through formal request to the program director. The
length of the leave will be determined by the program director based upon an individual’s particular
circumstances and the needs of the department, not to exceed 12 weeks in any 12-month period. The
resident/fellow shall be granted, upon request, up to 6 weeks paid maternity leave for birth or 2 weeks paid
leave for adoption. After using paid maternity leave and all unused vacation, any additional leave will be
without pay. Two weeks paid paternity leave will be granted upon request to the program director. Estimated
periods for Family Leave must be submitted to the Surgical Education Office at the time the circumstances
necessitating leave arise.
Nursing mothers have access to lactation rooms on both the University and Riverside campuses. If
rotating at another site, contact the Medical Staff office for locations.
Riverside: East Bldg., 5th floor, Room M555
University: Main Hospital, 4th floor, Room 4-106
Sick Leave Policy
In the event of illness, the affected resident/fellow is personally responsible for notifying the faculty
member of the affected service and the Surgical Education Office or Fellowship Director’s Office as soon as
the resident/fellow knows that the illness will cause an absence from clinical responsibilities. Sick leave will
be approved only for legitimate illness. A physician’s note may be requested to support the resident/fellow’s
request for sick leave. If the above policy is not followed, the absence will be counted as vacation time. It is
the responsibility of the resident and the program director to ensure that Board eligibility requirements are met
within the original residency period or alternative arrangements are made.
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SECTION 3 - INSTITUTION RESPONSIBILITIES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation
Services; Master Affiliation Agreements or Institution Affiliation Agreements; Program Letters of Agreement;
Confirmation of Receipt of Program Policy Manuals; Designated Institution Official Designee Policy; Duty Hour
Monitoring at the Institution Level Policy and Procedure; Experimentation and Innovation Policy; Funding; GME
Competency Teaching Resources and Core Curriculum; Graduate Medical Education Committee (GMEC)
Responsibilities; Graduate Medical Education Committee Resident Leadership Council Responsibilities; Institution and
Program Requirements; Internal Review Process; International Medical Graduates Policy; New Program Process;
Orientation; Visa Sponsorship Policy).
SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student
Academic Complaints; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination
Reporting; Sexual Assault Victim’s Rights Policy; Dispute Resolution Policy)
SECTION 5 - GENERAL POLICIES AND PROCEDURES
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for
Medical School Policies on the following: Academic Health Center (AHC) Student Background Study Policy; Background
Study Policy and Procedure; Academic Incivility: Resources for Dealing with Harassment; Applicant Privacy Policy;
Appointment Letter Policy and Procedure; Blood Borne Pathogen Exposure Policy; Certificate of Completion Policy;
Classification and Appointment Policy; Compact for Teaching and Learning; Disability Policy; Disaster and Local
Extreme Emergent Situation Planning Policy and Procedure; Documentation Management Requirements Policy; Dress
Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours/Prioritization of On-Call Room
Assignments; ECFMG/J1 Visa Holders: Documentation Required for FMLA; Effective Date for Stipends and Benefits
Policy; Eligibility and Selection Policy; Essential Capacities for Matriculation, Promotion and Graduation for U of M
GME Programs; Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and
Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and Procedure; Licensure
Policy: Life Support Certification Policy; Moonlighting Policy; National Provider Identification (NPI) Policy and
Procedure; National Residency Matching Program (NRMP) Fees Policy; Nepotism Policy; Observer Policy; Post Call
Cab Voucher Policy (UMMC-F; HCMC); Registered Same Sex Domestic Partner Policy; Release of Contact Information
for Solicitation Purposes Policy; Residency and Fellowship Agreement Policy and Procedure; Residency Management
Suite (RMS): Information Maintenance for Participating Hospitals; Residency Management Suite (RMS): Updating and
Approving Assignments and Hours in the Duty Hours Module of RMS; Restrictive Covenants; Social Networking Policy;
Standing and Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy; Supervision
Policy; Trainee File and Document Retention Policy; Training Program and/or Institution Closure or Reduction Policy;
Transitional Year Policy; USMLE Step 3 Policy; Vendor and Conflict of Interest Policy; Verification of Training and
Summary for Credentialing Policy; Without Salary Appointment Policy ).
Introduction
Welcome to the University of Minnesota Surgical Critical Care Program. Your educational experience
will be based on several approaches to give you the background necessary to complete a fellowship in surgical
critical care:
1.
2.
3.
4.
Organized didactic experiences
Self study of core materials
Directed and self-study of current critical care literature
Patient care experience at an advanced level
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Specific learning objectives are addressed in each site’s “specific goals and objectives”. Each of these
topics will be addressed by didactic teaching, self-study, and teaching on rounds. You will be evaluated during each
rotation and overall in several ways:
1.
You are expected to display mastery of the material as evidenced by its accurate application in the
patient care setting;
2.
You are expected to be able to teach mastered material to residents and students during clinical
teaching rounds;
3.
You are expected to perform at least at the 50th percentile on the critical care in-service exam
(MCCKAP).
4.
You are expected to pass the American Board of Surgery exam in Surgical Critical Care.
The core Surgical Critical Care core curriculum is based on literature readings and Abrams’ Surgical
Critical Care, 2nd edition. This book is available as an e-book through the University Library System
SURGICAL CRITICAL CARE FELLOWSHIP TRAINING PROGRAM
A.
Goals and Objectives:
Fellowship requirements are outlined below and correspond with the requirements of the ACGME,
“Program Requirements for Residency Education in Surgical Critical Care” and “Program Requirements for
Residency Education in the Subspecialties of General Surgery”, and “Common Program Requirements”. In
addition, site specific requirements are outlined in the handouts entitled, “SICU Fellows: U of M Rotation,
“SICU Service – University of Minnesota Medical Center - Fairview”, “SICU Fellows: VA Rotation”,
“Regions Medical Center Surgical ICU Service: Goals and Objectives”, “Hennepin County-SICU Service”,
and “NMMC TNICU Goals and Objectives”.
Fellows are required to take the Multidisciplinary Critical Care Assessment Program (MCCKAP) exam
during the last half of their fellowship year. This exam is used as a tool to assist fellows in preparation for the
American Board of Surgery’s Surgical Critical Care Exam.
B.
Training/Graduation Requirements
1.
The subspecialty program in surgical critical care medicine is 1 year in duration (with an optional
additional research year) and contains all of the educational experiences and program content required for an
accredited training program. A certificate of completion is awarded to all fellows who successfully complete
their clinical year as determined by evaluations assessing their organizational, technical, clinical,
interpersonal/communication, and administrative/management skills. Upon completion, board certified fellows
are eligible to take the exam for Added Qualifications in Critical Care.
2.
The clinical experience includes opportunities to manage inpatients with a wide variety of diseases. The
trainee will assume continuing responsibility for acutely and chronically ill patients.
3.
There are 12 months of direct patient care responsibility in critical care units. You will spend 3 months
at critical care units at University of Minnesota Medical Center, 2 months at Regions Hospital (a Level I trauma
center), 2 months at Hennepin County Medical Center (a Level I trauma center), 2 months at North Memorial
Medical Center, and 1 month at the V.A. Medical Center.
14
4.
There is the option of 2 months of elective time during the 12-month clinical year. This elective time
may consist of electives in medical critical care, research, pediatric critical care, neonatal intensive care,
echocardiography, trauma, and burn care.
5.
The primary training site for the University of Minnesota program is the University of Minnesota
Medical Center. This site features accredited subspecialty programs in pulmonary critical care, cardiovascular
surgery, transplantation and surgical infectious diseases, as well as general surgery. There will be extensive
formal and informal interactions among trainees in these accredited programs and the Surgical Critical Care
Program.
6.
The trainees will have extensive exposure to the care of surgical patients at all sites and trauma patients,
at Regions Medical Center, North Memorial Medical Center and Hennepin County Medical Center, during their
training program.
7.
The University of Minnesota has policies in place that ensures appropriate educational resources will be
devoted to surgical critical care training.
C.
Curriculum/Specific Program Content
Didactic Teaching
Didactic conferences consist of site-specific conferences (outlined in each site description) and programwide conferences.
Program-wide Conferences
a. At the Tuesday ICU Conference, speakers cover specific critical care topics and highlight areas
where fellows have scored lower on the MCCKAP exam in previous years.
b. Monthly journal club occurs the 1st Wednesday of the month. Articles are assigned for review
by critical care fellows. Topics and cases are also presented. (Topics are chosen based on identified
need, as mentioned above.)
c. Quarterly ICU meetings involve a forum for program issues to be presented and program
suggestions/improvements discussed. Meetings are hosted by a different site each time, except for
the last meeting in June. The June meeting is split into two parts. The first part includes the fellows
and consists of a review and evaluation of the year. The second half is without the fellows and
consists of a review of faculty evaluations completed by the fellows and a review of the entire
program by the faculty. Any changes for the following year are discussed.
d. SCCM Annual Meeting: Fellows must attend; critical care section will usually sponsor fellows.
e. The last Wednesday of the month is a combined Pulmonary/Surgical Critical Care Conference:
The conference covers RRC required topics and is directed by faculty from UMMC-F, HCMC,
Regions, NMMC and the MINNEAPOLIS VA HEALTH CARE SYSTEM. Fellows will be
expected to do a case presentation approximately every 6 months for this conference.
Self Study
The textbook used for this fellowship is Abrams’ Surgical Critical Care, 2nd edition (available either at
the University Bookstore or as an e-book from the University Library). In addition, each site has
specific readings (included in syllabus from each site) of current literature.
15
Teaching
An important part of education is the combined education of residents and students at a less advanced
stage of training. You will teach residents and students during your rotations as appropriate. You may
be assigned specific lecture topics at each site for presentation to medical students and/or residents. We
will frequently use you to teach and evaluate in the simulation lab (SimPORTAL).
Research
An important part of your critical care training is at least an exposure to clinical research. You will
attend research meetings at each site, participate in project development, screening, and patient
enrollment in clinical protocols, and write up research experiences as assigned. An optional additional
experience of from 6 months to one year is available to ICU fellows either before or after their clinical
rotations. This experience requires advanced planning. If you are interested, contact the program
director for further information.
Administrative
Each critical care trainee is expected to acquire those skills required to organize, administer, and direct a
critical care unit and work effectively as a member of an interdisciplinary team. In order to do this, each
trainee will be given graded responsibility, as their level of competence dictates, for making decisions
about admissions to the critical care unit, appropriateness of care plan, and discharge from the critical
care unit. Each trainee will accompany the critical care staff physician to the monthly critical care
committee and quality improvement committee meetings at each site where these issues are reviewed
and the process of continuous quality improvement is implemented. Each trainee is expected to
understand the quality improvement process and to actively participate in it as their level of competence
dictates throughout their clinical training. Attendance at these meetings is very important and will be
monitored.
D.
ACGME Competencies
All University of Minnesota Medical School Residency/Fellowship training programs define the specific
knowledge, skills, attitudes, and educational experiences required by the RRC to ensure its residents/fellows
demonstrate the following:
Patient care that is compassionate, appropriate, and effective for the treatment of health problems and
the promotion of health. Fellows will gain competence in the performance and application of the following
critical care skills:
a. Respiratory: airway management, including endoscopy and
management of respiratory systems
b. Circulatory: invasive and noninvasive monitoring
techniques, including trans-esophageal and pericardial
cardiac ultrasound and application of transvenous
pacemakers; computations of cardiac output and of
systemic and pulmonary vascular resistance; monitoring
electrocardiograms and management of cardiac assist devices
c. Neurological: the performance of complete neurological
examinations; the use of intracranial pressure monitoring
techniques and of the electroencephalogram to evaluate
cerebral function; application of hypothermia in the
16
management of cerebral trauma
d. Renal: the evaluation of renal function; peritoneal dialysis
and hemofiltration; knowledge of the indications and
complications of hemodialysis
e. Gastrointestinal: utilization of gastrointestinal intubation
and endoscopic techniques in the management of the
critically ill patient; application of enteral feedings;
management of stomas, fistulas, and percutaneous catheter
devices
f. Hematologic: application of autotransfusion; assessment of
coagulation status; appropriate use of component therapy
g. Infectious disease: classification of infections and
application of isolation techniques, pharmacokinetics, drug
interactions, and management of antibiotic therapy during
organ failure; nosocomial infections; indications for
applications of hyperbaric oxygen therapy
i. Nutritional: application of parenteral and enteral
nutrition; monitoring and assessing metabolism and nutrition
ii. Monitoring/bioengineering: use and calibration of
transducers, amplifiers, and recorders
iii. Miscellaneous: use of special beds for specific
injuries; employment of pneumatic antishock
garments, traction, and fixation devices
Medical knowledge of established and evolving biomedical, clinical, epidemiological and socialbehavioral sciences and the application of this knowledge to patient care. Fellows to acquire advanced
knowledge of the following aspects of critical care, particularly as they relate to the management of patients
with homodynamic instability, multiple system organ failure, and complex coexisting medical problems:
a. Cardiorespiratory resuscitation
b. Physiology, pathophysiology, diagnosis, and therapy of
disorders of the cardiovascular, respiratory, gastrointestinal,
genitourinary, neurological, endocrine, musculoskeletal,
and immune systems, as well as of infectious diseases
c. Metabolic, nutritional, and endocrine effects of critical illness
d. Hematologic and coagulation disorders
e. Critical obstetric and gynecologic disorders
f. Trauma, thermal, electrical, and radiation injuries
g. Inhalation and immersion injuries
h. Monitoring and medical instrumentation
i. Critical pediatric surgical conditions
j. Pharmacokinetics and dynamics of drug metabolism and
excretion in critical illness
k. Ethical and legal aspects of surgical critical care
l. Principles and techniques of administration and management
m. Biostatistics and experimental design
Practice-based learning and improvement that involves investigation and evaluation of their own patient
care, appraisal and assimilation of scientific evidence, and improvements in patient care based on constant
17
self-evaluation and life-long learning. Fellows are expected to develop skills and habits to be able to meet the
following goals:
a. Identify strengths, deficiencies, and limits in one’s knowledge and expertise
b. Set learning and improvement goals
c. Identify and perform appropriate learning activities
d. Systematically analyze practice using quality improvement methods and implement changes
with the goal of practice improvement
e. Incorporate formative evaluation feedback into daily practice
f. Locate, appraise, and assimilate evidence from scientific studies related to their patients’
health problems
g. Use information technology to optimize learning, and
h. Participate in the education of patients, families, students, residents and other health
professionals..
Interpersonal and communication skills that result in effective information exchange and teaming with
patients, their families, and other health professionals. Fellows are expected to:
(1) communicate effectively with patients, families, and the
public, as appropriate, across a broad range of socioeconomic and cultural backgrounds;
(2) communicate effectively with physicians, other health professionals, and health related
agencies;
(3) work effectively as a member or leader of a health care team or other professional group;
(4) act in a consultative role to other physicians and health professionals; and,
(5) maintain comprehensive, timely, and legible medical records, if applicable.
Fellows must demonstrate professionalism as manifested through a commitment to carrying out
professional responsibilities and an adherence to ethical principles. Fellows are expected to
demonstrate:
(1) compassion, integrity, and respect for others;
(2) responsiveness to patient needs that supersedes self interest;
(3) respect for patient privacy and autonomy;
(4) accountability to patients, society and the profession; and,
(5) sensitivity and responsiveness to a diverse patient population,
including but not limited to diversity in gender, age, culture, race, religion, disabilities,
and sexual orientation.
Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness
to the larger context and system for health care and the ability to effectively call on system resources to provide
care that is of optimal value. Fellows must demonstrate the ability to:
(1) work effectively in various health care delivery settings and
systems relevant to their clinical specialty;
(2) coordinate patient care within the health care system
relevant to their clinical specialty;
(3) incorporate considerations of cost awareness and risk benefit
analysis in patient and/or population-based care as
appropriate;
(4) advocate for quality patient care and optimal patient care systems
(5) work in interprofessional teams to enhance patient safety
and improve patient care quality; and
(6) participate in identifying system errors and implementing
potential systems solutions.
18
E.
Duty Hours
Duty Hours are defined as all clinical and academic activities related to the training program, ie, patient
care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of
patient care, time spent in-house during call activities, and scheduled academic activities such as conferences.
Duty hours DO NOT include reading and preparation time spent away from the duty site.
Duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all inhouse call activities.
Residents/Fellows are provided with 1 day in 7 free from all educational and clinical responsibilities,
averaged over a 4-week period, inclusive of call.
The training program provides adequate time for rest and personal activities, which consists of a 10hour time period provided between all daily duty periods and after in-house call.
Surgical Critical Care fellows currently rotate at five sites: the UMMC, Regions Hospital, the V.A.
Medical Center, North Memorial Medical Center and Hennepin County Medical Center. There is no in-house
call for ICU fellows at any of the sites. There is no cross-coverage of surgery resident and ICU fellow call.
Current assignments at each site are as follows:
UMMC-F: ICU fellows are on home call 1 to 2 weeks per month as first call. When on call, they round in
the ICU daily (including Saturday and Sunday) and receive calls from the in-house resident regarding issues
with the ICU patients. On average, fellows return from home to the hospital once weekly.
Regions: ICU fellows are on home call every other week as first call in the ICU. When on call, they round
in the ICU daily (including Saturday and Sunday) and receive calls from the in-house resident regarding issues
with the ICU patients. On average, fellows return from home to the hospital once weekly. There is a trauma
attending in house at night to provide backup assistance in the ICU if necessary.
MINNEAPOLIS VA HEALTH CARE SYSTEM: ICU fellows are on first call from home during the
week as first call in the ICU. They alternate weekends on call with attendings at the VA Hospital. It is
infrequent for fellows to have to return to the hospital after regular duty hours.
HCMC: ICU fellows are on home call every other week as first call in the ICU. When on call, they round
in the ICU daily (including Saturday and Sunday) and receive calls from the in-house resident regarding issues
with the ICU patients. On average, fellows return from home to the hospital once weekly.
NMMC: .ICU fellows are on home call for operative trauma 3-4 days per week. They round in the
TNICU daily and on weekends when on weekend call.
Justification for an extension of duty are limited to reasons of required continuity for a severely ill or
unstable patient, academic importance of the events transpiring, or humanistic attention to the needs of the
patient or family. Under these circumstances the fellow must hand over care of all other patients and document
the reasons for remaining to care for the patient in question and submit that documentation in every
circumstance to the program director through the RMS system.
19
Duty Hours Tracking
1.
All Resident/Fellows* will accurately log their duty hours into the Residency Management System Duty
Hours Tracking Module.
The website address is https://www.new-innov.com/Login/Login.aspx?Hospital=MMCGME
2.
Data must be entered and updated weekly.
Time reports to date show that ICU fellows are well within the ACGME requirements (Weekly hours
range from 50 on elective rotations to 55-65 on the above rotations). At least one day in seven is free of patient
care responsibilities.
To use Residency Management Suite:
You will need to use an IBM compatible computer.
1. To access RMS, open your Internet browser to access RMS.
Website: www.new-innov.com/login.htm
Institution’s login: mmcgme
Username: user specific
2. Password: user specific
**If you do not remember your username and/or password, contact the Surgical Education
Office, Michelle Lunden directly at 612-626-2590 or the Surgical Administrative Center RMS
coordinator at 612-626-4959.
3. It is highly recommended to bookmark this page. By doing that, you will not have to enter
mmcgme every time.
4. Once in the system, you will see a menu on the top of the screen for your options. Under Main
choose Duty Hours. Once to the Duty Hours main page there will be a bold header saying
Logging Hours. Click on the My Duty Hour link under that. On this screen you will see 4
Data Entry Views to choose from. PLEASE NOTE: You can choose whatever method you
want; however, it has been found that the Graphical entry screen is the best for your specific
specialty. Because of this, only directions on Graphical and Vacation/Leave are outlined
below.
Graphical
The screen that RMS defaults to is the graphical data entry screen. Pick the day to log
hours off the calendar then click the continue button. From this screen you will see
the full week around the day you picked. Choose the appropriate Assignment
Definition from the drop down box and fill in duty hours by color coding the daily
hours. You can fill in multiple days and multiple assignments all on one screen.
Click on save when done. You can also edit in bulk here if changes need to be made
to past assignments. This will be used most often to log hours after they have
happened.
Vacation/Leave
This screen allows you to pick the correct Time Away designation to track vacation
and leave. Make sure you have the correct Assignment Definition chosen and then
simply click on the first day of vacation in the first calendar and the last day of vacation
in the second calendar. Usually vacation time will be marked as: Time Away-Does NOT Extend TrainingShort. This Assignment Definition should be chosen if you will be gone for 14
days or less.
20
Once hours have been logged on the system, it is important to make sure there are no conflicts and that
all hours are approved. To do this scroll over My Duty Hours and click on Approve My Hours. You
can also click on the blue Approve Existing Hours link on the main Duty Hour page. After picking
the appropriate date range the only hour that will show up are hours either not approved or in conflict
(these will be marked with an asterisk). To clear up conflicts either edit the entries or mark the
incorrect one with Did Not Work. Make sure to approve all hours worked with Approve Selected
Entries.
Make sure to logout of the system until you are ready to log more hours.
F.
On Call Schedules
Call schedules for all sites are distributed on the first day of rotation at each site.
In-house call is defined as those duty hours beyond the normal work day when residents/fellows are
required to be immediately available in the assigned institution. In-house call must occur no more frequently
than every third night averaged over a four hour period.
Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.
Residents/fellows may remain on duty for up to 6 additional hours to participate in didactic activities, transfer
care of patients, and maintain continuity of medical and surgical care.
G.
Supervision, Faculty and Organization of the Staff
1.
The training program is directed by Dr. Jeffrey Chipman who is certified in Surgical Critical Care by the
American Board of Surgery.
2.
The faculty at UMMC-F, the primary training site, consists of 8 individuals. Each devotes at least 20
hours/week to teaching, research, administration, and the critical evaluation of the performance and progress of
our critical care trainees. The faculty to trainee ratio is always greater than 2 to 1. At all times there are two or
more faculty based at the University of Minnesota who provide didactic support to the training program.
Faculty in anesthesiology, pulmonary medicine, medicine, neurology, and pharmacy also participate in our
educational program.
3.
Critical care teaching staff have privileges to admit, treat, and discharge patients from the Critical Care
units.
4.
A collegial relationship exists between the director of the critical care training program and teaching
staff in general surgery, transplantation, neurosurgery, cardiothoracic surgery, urology, orthopedic surgery,
pulmonary/critical care medicine, pediatric critical care, and obstetrics and gynecology to enhance the
educational opportunity for all trainees.
21
Lines of Responsibility
University of Minnesota Medical Center - Fairview
ICU Site Director
Jeffrey Chipman, M.D.
ICU Attending On Call
ICU Resident
Surgical Issues
Surgery Chief
Res., Attending
Surgery/Anesthesia Resident/Intern
or Cross Cover
Patient
Regions Hospital
ICU Site Director
Bruce Bennett, M.D.
ICU Attending On Call
ICU Resident
Surgical Issues
Surgery/Anesthesia Resident/Intern
or Cross Cover
Patient
22
Surgery Chief Resident
Attending
V.A. Medical Center
ICU Site Director
Roderick Barke, M.D., Ph.D.
ICU Attending On Call
ICU Resident
Surgical Issues
Surgery Chief
Resident/Staff
Surgery Resident/Intern
or Cross Cover
Patient
Hennepin County Medical Center
ICU Site Director
Robert Quickel, M.D.
ICU Attending On Call
ICU Resident
Surgical Issues
Surgery Resident/Intern
or Cross Cover
Patient
Specific duties of the ICU resident are outlined in each site rotation description.
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Surgery Chief
Resident, Attending
North Memorial Medical Center
TNICU Site Director
Alan Beal, M.D.
ICU Attending On Call
ICU Resident
Surgical Issues
Trauma Attending
Patient
Specific duties of the ICU resident are outlined in each site rotation description.
G.
Graded Responsibility
1.
Fellows are encouraged to assume increasing levels of responsibility commensurate with their progress in
experience, skill, knowledge and judgment. Upon successful completion of the fellowship program, residents
have the skills necessary to assume a lead role in a Surgical Critical Care unit.
H.
Facilities and Resources
1.
Modern facilities are available at each of the primary training sites to support the Surgical Critical
Care training program. These include the University of Minnesota Medical Center - Fairview, the VA
Medical Center, Regions Hospital, North Memorial Medical Center and Hennepin County Medical
Center.
2.
Critical care units at each training site are located in designated areas within the hospital and are
designed specifically for the care of critically ill patients. Each hospital has the equivalent of a medical
intensive care unit, a surgical intensive care unit and a coronary care unit. These facilities are judged
adequate by the appropriate hospital accreditation organizations to care for patients with acute myocardial
infarction, severe trauma, shock, open heart surgery, major thoracic or abdominal surgery, and severe
neurological and neurosurgical conditions.
3.
In each unit where a critical care trainee is assigned, the average daily census is greater than six
patients per trainee. Each unit consists of specially trained nurses and technicians who are skilled in
critical care instrumentation, respiratory function, and laboratory medicine. At each facility, a supporting
laboratory is available to provide complete and prompt laboratory evaluation. Modern imaging services
and an active emergency service are available as well as nutritional support services.
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UMMC-F On Call Rooms
The University of Minnesota Medical Center - Fairview has 18 on-call rooms located on the 4th
floor of the Mayo building. All rooms have punch code security access which is changed daily, and a
security monitor on duty from 2:00 pm-8:00 am, and contain a desk, TV, radio clock, and air
conditioning. On-call Residents, on-call Medical Students, on-call fellows, on-call attending physicians
and certain on-call hospital staff are eligible to check-in to a call room. Check-in can only occur during
the designated check-in hours of 2:30 pm until 7:00 am. To check-in, go to the check-in desk located in
the Resident Lounge (Mayo C-496). The check-in desk is staffed by a security monitor during set hours 7
days/week and will require you to present your hospital ID badge. The security monitor will assign you a
room, the access code, and the locker room and lounge access codes. All individuals must be out of their
rooms by 8:00 am. Housekeeping will come to begin cleaning by 7:00 am. If you wish to sleep until 8:00
am, make sure your DO NOT DISTURB sign is indicated on your door. No room is checked out to the
same service two days in a row. Belongings left in room past noon will be removed and kept in a security
locker. Belongings can be picked up anytime after 2:30 pm from the security monitor. Any questions,
call 612-273-7497.
UMMC-F Resident Lounge
The Resident Lounge at University of Minnesota Medical Center - Fairview is located in Room 6501 in Unit J and is available 24 hours per day for residents from all specialties. The room is accessible
by punch code access, which is changed weekly, or by open door when security monitor is on duty.
TV/VCR, computers, and phones with access to the main hospital are available. There is also a partially
stocked kitchen with refrigerator, coffee/tea makers, microwave, and toaster.
I.
Laboratory/Pathology/Radiology Services
Laboratory, pathology, and radiology services are readily available through University of
Minnesota Medical Center - Fairview. Below is the contact information and location of each of these
medical services:
Fairview Diagnostic Laboratories
Mayo Medical Building, Room D-293
420 Delaware Street SE, MMC 198
Minneapolis, MN 55455
Tel: 612-273-7838, Fax: 612-273-0183
Pathology
Pathology Department (also, Pathology Surgical, May Room 422, MMC 76)
Mayo Medical Building, Room C-477
420 Delaware Street SE, MMC 609
Minneapolis, MN 55455
Tel: 612-273-5920
Fax: 612-273-1142
Radiology
Radiology Department (also, Reading Rooms, Registration)
Harvard at East River Road (UH), Room 2-300 (all divisions: MMC 292)
Minneapolis, MN 55455
Tel: 612-273-6004, Fax: 612-273-8954
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Interventional CV Radiology, UH-2-300
Tel: 612-273-5040
Fax: 612-273-7500
Radiology Engineering, UH 2-493
Tel: 612-273-6801
Fax: 612-273-6887
Radiology Film Desk Hospital, UH 2-403
Tel: 612-273-5777
Fax: 612-273-7515
J.
Medical Records
Patient records can be accessed either via EPIC, PACS and Eclipsis Electronic Medical Records
(EMR) systems, or by calling University of Minnesota Medical Center – Fairview’s (UMMC-F) Health
Information Management (HIM) offices at 612-626-3535.
For official medical record retrieval, patients are to contact the UMMC’s HIM offices at:
University of Minnesota Medical Center
ATTN: Release of Information
420 Delaware Street SE, MMC 601
Minneapolis, MN 55455
Tel: 612-626-3535
Fax: 612-273-2345
K.
Security/Safety
The Security Monitor Program (SMP) is a branch of the University of Minnesota Police
Department. SMP offers a walking/biking escort service to and from campus locations and nearby
adjacent neighborhoods. This service is available completely free to students, staff, faculty, and visitors
to the University of Minnesota – Twin Cities campus. To request an escort from a trained student security
monitor, please call 624-WALK shortly before your desired departure time and walk safe.
University of Minnesota Medical Center – Fairview also employs security officers who are on
duty 24 hours a day to respond to emergencies and to escort persons to and from the parking facilities.
Call 612-273-4544 if you wish to have an escort, and a security officer will meet you at your location.
L.
Monitoring of Physician Well Being
The Surgical Critical Care Program is committed to monitoring the well being of the fellows in the
training program. Daily contact between faculty and fellows provides opportunities to observe fellows on
a regular basis. Faculty observe for signs of fatigue, distraction, tardiness, or other signs that could
indicate overwork or personal problems. The GME office provides an orientation for all incoming
residents and fellows which includes the topic of Physician Well Being. During this orientation, fellows
are made aware of the confidential Resident Assistance Program that is available for resident/fellows and
their families should they require outside assistance.
The University of Minnesota Medical School has contracted with Sand Creek to provide services
including mental or emotional conditions inhibiting performance or learning, and drug or alcohol
related dysfunction for you or anyone in your family. Sand Creek’s counselors have particular expertise
- 26
in dealing with the needs of individuals in their residency training programs. In contacting them, you
will receive confidential help in determining the problem, what should be done, and how to go about it.
Your privacy is a primary concern. That is why an outside firm provides your RAP services.
Your counselor will keep everything strictly confidential. Nothing is disclosed to your faculty or to others
without your written consent.
The RAP services cost you nothing for the initial assessment. Depending on your needs, you may
be referred to outside sources of help. If so, you will receive assistance in finding an appropriate,
affordable resource. Your health insurance does provide portions of coverage for personal counseling,
psychiatric care, chemical dependency and drug treatment.
Whether you have an emergency on your hands or you simply need someone to help you sort
things out, there is help. A counselor will quickly respond to your call. When the Sand Creek’s office is
closed, an answering service will take your call and relay your message. In an emergency, a counselor
will contact you immediately.
You may discuss your concerns with a counselor at the Sand Creek Office or a counselor will
meet you at your hospital. The RAP is designed to be flexible and to accommodate your busy schedule.
Sand Creek
333 North Main Street, Suite 203
Stillwater, MN 55082
Tel: 651-430-3383 or 1-800-632-7643
http://www.med.umn.edu/gme/residents/rap
M.
Communication Policy
1.
All general announcements and information will be disseminated via e-mail.
2.
Residents/Fellows are required to maintain an active e-mail address and access it at least twice
weekly.
3.
Resident/Fellows may use a personal e-mail address in lieu of their University X.500 address but
must forward their University address to their personal address. Notifications from systems such as RMS
must use the U of M address.
N.
Grand Rounds Compliance
Attendance at Grand Rounds is mandatory for Surgical Critical Care Fellows while rotating at the
University of Minnesota Medical Center unless involved in emergent patient care or on vacation.
O.
Dress Code Policy
All Department of Surgery Residents and Fellows will comply with the University of Minnesota,
Medical School, Graduate Medical Education Committee Dress Code Policy listed below.
In addition, all Department of Surgery Residents and Fellows will dress appropriately such that
while attending conferences and when participating in all training activities shirts/ties and business attire
are worn. Post call residents must be neatly groomed and clean.
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University of Minnesota Medical School, Graduate Medical Education Committee
Dress Code Policy
Resident/fellows are expected to be neat, clean, and orderly at all times during the performance of
training program activities. Jewelry, clothes, hairstyle, and fragrances should be appropriate of duties in
the hospital or clinic.
The resident/fellow’s identification badge is to be worn whenever the resident/fellow is involved in
clinical and administrative duties.
Residents/fellows are expected to dress accordingly to generally accepted professional standards
appropriate for their training program. Each training program may set more specific guidelines for dress
code standards in its program. Where safety is a factor, resident/fellows should use common sense in
choosing clothing and shoes for training activities.
Scrub suits are appropriate for designated area, e.g. Operating Room, Labor & Delivery. In all
other areas, a white coat must be worn over the scrub suit.
P.
Moonlighting
The ACGME and the University of Minnesota allows an experience in moonlighting for SICU
fellows in our program in approved circumstances. 1) The moonlighting workload should not interfere
with your duties and learning experience as a Surgical ICU fellow and you should be appropriately
credentialed at the institution where you are moonlighting. Moonlighting must take place outside of your
regular duty hours and you must ensure adequate transition of patient care to a responsible attending
physician after your moonlighting “shift”.
While we have no established maximum number of hours worked per week, we ask you to use
common sense in your moonlighting experience, as your education will suffer if you are fatigued during
your fellowship hours.
If you elect to moonlight, you must request and receive approval in writing from the Program
Director. The request must include the location of the moonlighting activity and the expected number of
hours per month. Hours spent moonlighting must be included in duty hours logged.
Q.
American Board of Surgery – Requirements for Certification in Surgical Critical Care
Certification of Added Qualifications in Surgical Critical Care by the American Board of Surgery attests
that one has acquired a detailed knowledge of the discipline and has developed technical and other skills to the
degree that the individual may be judged to deserve recognition as a Specialist in Surgical Critical Care with the
ability to provide that care to patients. Fellows who have not yet completed their residency may take the exam after
successfully completing the fellowship, but will not receive a certificate until completion of their residency.
General Requirements for Certification of Added Qualifications:
-Be a Diplomate of the American Board of Surgery.
-Have a currently registered full and unrestricted license to practice medicine in the United States or
Canada.
-Must have successfully completed a Surgical Critical Care fellowship accredited by the ACGME.
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-Successfully complete an examination process in Surgical Critical Care administered by the American
Board of Surgery.
R.
Evaluations:
The Surgical Critical Care Fellowship Program utilizes a 360˚ evaluation system for the fellows. Fellows
evaluate their own progress after each core rotation, and are evaluated by faculty, residents and nursing staff from
their rotation site. These evaluations are reviewed by the fellowship director or designee and discussed with each
fellow during their midyear and end of year evaluation meetings.. Upon completion of the fellowship year,
evaluations from the entire year as well as rotation and program evaluations are reviewed with each fellow during
their exit interview. We are currently using a combination of hard copy evaluations(nursing staff & self evaluation)
as well as online evaluations through the New Innovations RMS website.
The program, rotation, and faculty are in turn evaluated by the fellows. The program evaluation occurs at
the completion of the fellowship year, while the rotation and faculty evaluations are performed at the end of each
rotation. Our program uses Residency Management Suite (RMS) to complete evaluations. The Education Office
will train you on the system and provide you with your login and password. For any questions related to this
system, contact either Education Office (626-4959) or Debbie (625-2684).
S.
Patient Log
Fellows are required to keep a log of patients they see at each of the sites. The ACGME requires
fellows to maintain a list of all patients. In addition, patients that meet specific criteria (see following
page) should be indicated in the log as “Include in SCCIC log”. At the end of the fellowship year a
report can be generated of all patients and also the subset for the SCCIC log. This must be turned in to
the administrative office as a requirement for completion of the Surgical Critical Care fellowship. Keep a
copy of all your patient lists for completing the application form for ABS certification in Surgical Critical
Care. Log-ins and passwords will be giving to you during the SICU orientation. The ACGME website is
www.acgme.org. Click on Data Collection on the left side and you will get to the log-in screen.
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SURGICAL CRITICAL CARE LOG
Please insert the operative log for each SCC resident.
Essentials in Critical Care Management
Select the patients who best represent all the essential aspects of intensive care unit management. Each resident is to develop a
Surgical Critical Care Index Case (SCCIC) log of twenty patients who best represent the full breadth of critical care
management. At least two out of the seven categories listed below should be applicable to each chosen patient. The
completed SCCIC log should include experience, with at least one patient, in each of the following essential categories:
ventilator dependent, hemorrhage, hemodynamic lability, multiple organ failure, dysrhythmia, and nutritional support.
1.
2.
3.
4.
5.
Diagnosis: Pick list by ICD 9/10 Code
Ventilator: yes/no
Hemorrhage: yes/no
Hemodynamic lability requiring vasoactive/inotropic agents: yes/no
Organ failure
a. Renal: yes/no
b. Hepatic: yes/no
c. Endocrine: yes/no
d. CNS: yes/no
6. Dysrhythmia: yes/no
7. Invasive monitors
a. Pulmonary Artery Catheter: yes/no
b. Central Venous Line: yes/no
c. Arterial line: yes/no
d. Intracranial Pressure monitor/continuous EEG/Lycox/Jugular Bulb oximetry: yes/no
8. Nutritional support
a. Enteral: yes/no
b. Parenteral: yes/no
9. Procedures (ICU-specific)
a. Airways management:
i. Endotracheal intubation: yes/no
ii. Tracheostomy: yes/no
1) Percutaneous
2) Open
b. Placement of vascular lines:
i. Central Venous Line: yes/no
ii. Pulmonary Artery Catheter: yes/no
iii. Peripheral Artery Catheter: yes/no
c. Tube thoracostomy: yes/no
d. Bronchoscopy: yes/no
e. Enteral access:
i. Transnasal gastric feeding tube: yes/no
ii. Transnasal small bowel feeding tube: yes/no
iii. Endoscopically assisted small bowel feeding tube access: yes/no
iv. Percutaneous endoscopic gastrostomy/jejunostomy: yes/no
10. Operations: list by CPT code all operations performed by the Critical Care Resident
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T.
Rotation Schedules
Rotation schedules are distributed during orientation.
Elective Rotations
Elective rotations from 1-2 months are available in several different areas of specialized training.
Possibilities include pulmonary critical care, pediatrics, NICU, burn, trauma, echocardiography,
anesthesia, interventional radiology, research, or other approved self designed elective. Electives must be
selected at the beginning of July in order to ensure placement. Fellows should discuss their options for
electives with the program director early in July if they have any questions.
SECTION 6 - ADMINSTRATION
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html
for Medical School Policies on the following: GME Administration Contact List, GME Administration by Job
Duty; GME Organization Chart)
Surgical Critical Care Sites and Contact List
**From University Phones, Dial “8” for an outside line; From Hospital Phones, Dial a “9”**
University of Minnesota Medical Center - Fairview:
PWB Bldg.
Room 11-115 Delaware St. SE, Minneapolis, MN 55455
Office Phone: 612-625-7911
Office Fax: 612-626-0439
Director
Faculty
Jeffrey G. Chipman, M.D. Assoc. Prof. of Surgery, 11-114 PWB Bldg.
612-626-5622
612-899-8771 Pager
Greg J. Beilman, M.D.,. Prof. of Surgery
612-625-7911
612-899-7108 (Pager)
Martin Birch, M.D., Asst. Prof. of Anesthesiology
612-624-9990
612-899-6019
Matthew Byrnes, M.D., Asst. Professor of Surgery
612-626-6840
612-899-7023
James Harmon, M.D., Asst. Professor of Surgery
612-899-8116
Mollie James, D.O., Asst. Professor of Surgery
612-899-2905
Kaysie Banton, M.D., Asst. Professor of Surgery
612-899-7169
Melissa Brunsvold, M.D., Asst. Professor of Surgery
612-899-
Fellowship Coord.
Debbie Bresina
612-625-2684
11-115b PWB Bldg.
Salary/Benefit Info
Teri Wolner
612-625-3926
11-145 PWB
4D SICU
UMMC operator
612-273-3044
612-273-3000
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AHC Help Desk (Computer 612-626-5100
Problems)
EPIC Helpline
612-672-6805
University Information
612-625-5000
Video & photography
Regions Hospital:
Department of Surgery
640 Jackson St.
Minneapolis, MN 55101
Office Phone: 651-254-1633
Office Fax: 651-254-1480
Director of SICU
Faculty
GME
Jerry Vincent
612-625-9463
Bruce A. Bennett, M.D. (on military leave)
North Bldg., 3rd flr, Ste. 2
651-254-1633
David J. Dries, M.D.
Michael McGonigal, M.D.
Gary Collins, M.D. (Interim Director)
Cassandra Palmer, M.D.
Deb Collier, Program Associate
Graduate Medical Education MS 11501G
Institute for Medical Education *
Regions Hospital
640 Jackson Street
St. Paul, MN 55101
651-254-1504 (office) 651-254-5044 (fax)
Deb.K.Collier@HealthPartners.Com
V.A. Medical Center:
Department of Surgery (112)
2J100, 1 Veterans Drive
Minneapolis, MN 55417
Office Phone: 612-725-2065
Office Fax: 612-725-2227
Director SICU
Rod Barke, M.D., Ph.D. Rm. 2J100
612-725-2065
612-660-7166 pager
SICU Faculty
Jerome H. Abrams, M.D.
Paul Druck, M.D.
Residency Coordinator
Linda Dent
612-467-3353
Orientation
Lisa Loyas
Lisa.Loyas@va.gov
HCMC:
Department of Surgery
701 Park Avenue
Minneapolis, MN 55 415
Director SICU
Faculty
Robert Quickel, M.D.
612-873-2810
612-527-3000 pager
Art Ney, M.D.
Chad Richardson, M.D.
Joan VanCamp, M.D.
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612-467-1330
Residency Coordinator
Phyllis Squiers
612-873-2849
NMMC
Trauma Institute
North Memorial Medical Center
3300 Oakdale Ave. N.
Robbinsdale, MN
Director TNICU
Alan Beal, M.D.
763-520-7647
612-589-7179 pager
Faculty
Mark Ahrendt, M.D.
Kevin Croston, M.D.
Eric Irwin, M.D.
John Cummings, M.D.
Matthew Byrnes, M.D.
Medical Staff Office
Deb Bement
deb.bement@northmemorial.com
763-520-5848
763-520-5554 fax
Tracey Worley
tracey.worley@northmemorial.com
763-520-1705
Susan Adler
susan.adler@northmemorial.com 763-520-1754
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Department of Surgery Administrative Contact List
Selwyn Vickers, M.D.
Professor and Chair
Program Director
Director of Graduate Studies
612-626-1999
Michael A. Maddaus, M.D.
Associate Program Director
Chairman, Surgical Education Council
612-624-9461
Daniel A. Saltzman, M.D., Ph.D.
PGY-1 Director
Assistant Professor
612-626-4214
Jeffrey Chipman, M.D.
Associate Residency Program Director
PGY-2 Mentor
Assistant Professor
612-625-7911
Greg Beilman, M.D.
PGY-3 Mentor
Associate Professor
612-625-7911
Todd M. Tuttle, M.D.
PGY-4 Mentor
Associate Professor
612-625-2991
Assistant: Cynthia Messer
Assistant: Sara Kloepper
Assistant: Cheryl Fish
Assistant: Colleen Powers
Assistant: Christine Vincent
Assistant: Tina Russell
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