CRITICAL CARE TRAINING MAKES TRAUMA CARE MORE ATTRACTIVE AS A CAREER

One recent report has prompted concern that surgical residents are no longer concerned in providing trauma care as a significant portion of their careers. In 1986, we linked our trauma and critical care services. We surveyed all chief residents who finished in the past 10 years, comparing the 5 years before the linking of trauma and critical care to the period since. Between 1982 and 1987, 3 of the 45 finishing residents (7%) pursued trauma fellowships, then trauma care as a career. Since 1987, 12 finishing residents (30% of the total and 33% of those pursuing fellowship training) trained in trauma/critical care. Nine currently pursue trauma care as a career. Two others are academic trauma surgeons without fellowship training and one other practices general surgery with trauma care as a main focus. Thus 12 of the 41 residents (30%) practice trauma care and 14 residents (34%) practice critical care. Residents finishing since 1987 were significantly more likely to respond that they are interested in trauma care, feel trauma care was attractive, and wish to have trauma care be a major portion of their careers. Those who chose not to pursue trauma care cited reasons similar to those described by Richardson and Miller. Other specialty interests were the most important factor in both time periods. Residents finishing after 1987 described the link between trauma care and critical care with a designated ICU service as strong positive influences. The understanding of resuscitation physiology gained in the ICU, including nonsurgical therapy, was felt to enhance trauma care, making it more attractive. In our system, trauma/critical care attending physicians were perceived as important role models. Critical care training enhances the trauma care experience. It is an important educational tool and makes trauma care more attractive as a career.