Surgical Critical Care and Acute Care Surgery Fellowship

Visit the Acute Care Surgery Division Website: https://rwjms.rutgers.edu/department/surgery/divisions#tab=panel-1

The ACS faculty consists of 14 fulltime fellowship trained academic trauma surgeons. Robert Wood Johnson University Hospital in New Brunswick, NJ is a quaternary referral center with 628 beds and is also home to the 100+ bed Bristol-Myers Squibb Children’s Hospital (BMSCH) and the Jack & Sheryl Morris Cancer Center which houses 96 inpatient beds. The Trauma Service at RWJUH is an ACS-verified Level I Adult Trauma Center and Level I Pediatric Trauma Center, providing comprehensive care for patients with complex blunt and penetrating injuries. With over 3,800 trauma activations annually, the service is among the highest-volume centers in the region. The Emergency General Surgery Service performs over 1300 complex cases annually and recently expanded to include an ACS led elective robotic surgical practice.

The Shock-Trauma Intensive Care Unit is a state-of-the-art, closed surgery ICU that cares for over 1100 critically ill patients per year. The SICU offers advanced critical care capabilities including sophisticated ventilator management, bedside bronchoscopy, tracheostomy and PEG placement, direct peritoneal resuscitation, continuous renal replacement therapy, and noninvasive hemodynamic monitoring. RWJUH supports the largest cardiac surgery program in the state performing more than 1700 cardiac surgeries annually. The Cardiovascular Surgery Intensive Care Unit provides specialized care to these patients with advanced heart failure and complex aortic disease in the 24 bed CVICU using advanced mechanical circulatory support including Impella devices, LVADs, RVADs intra-aortic balloon pumps, and VA and VV ECMO. 

Surgical Critical Care 1^st year

SICU                                                   5 months

CVICU                                                2.5 months

Neuro ICU                                          1 month

Airway/anesthesia                               0.5 months 

Trauma surgery                                   1 month

Somerset ICU                                     1 month

SICU at NJMS, Newark, NJ               1 month

Acute Care Surgery 2^nd year

Trauma                                                5 months

EGS                                                     5 months

Cardiac Surgery                                  1 month

Trauma surgery at NJMS                    2 weeks

Our fellowship incorporates a structured, tiered approach to graduated autonomy that is based on demonstrated merit, clinical performance, and faculty assessment. Fellows progress through 3 defined levels of responsibility in each year, beginning with closely supervised, collaborative patient care and advancing to independence in clinical decision making, operative management, and leadership of multidisciplinary teams. Advancement through these tiers is determined through formal, iterative faculty evaluations and scheduled review meetings that assess each fellow’s readiness to assume greater responsibility. This intentional framework ensures that fellows develop confidence and competence in a supportive environment, while maintaining patient safety as the highest priority. In the second year, fellows are credentialed as faculty at RWJUH in New Brunswick and Somerset and by completion of training, fellows are prepared to function with the autonomy and judgment expected of independent acute care surgeons and surgical intensivists. 

Dedicated time to fellow-level didactics is paramount to the Rutgers RWJMS SCC-ACS fellowship and includes the following curricula: This Week in SCORE, weekly journal club, bimonthly multidisciplinary critical care grand rounds, and monthly simulation. Fellows are integrated into all aspects of the ACS Division and participate in in quality improvement monthly conferences and initiatives. We have developed international relationships and global surgery partnerships that offer clinical, administrative, research, and trauma system development opportunities that will afford fellows personal and academic growth in global health roles. Robert Wood Johnson has a simulation-based training center, provides educational courses such as ATLS, ATOM, ASSET, and Disaster Life Support, for the region and is nationally recognized as a leader in disaster preparedness.

Lecture Series: 

1. Morning report (daily educational conference discussing new critically ill patients) 

2. “Surgical Critical Care Lecture Series” using the "This Week in SCORE" American Board of Surgery curriculum delivered weekly on Tuesdays

3. “Acute Care Surgery Lecture Series” involving journal club, simulation lecture series, and divisional RASR research meetings delivered weekly on Wednesdays

4. “Multidisciplinary Critical Care Grand Rounds” involving Rutgers Robert Wood Johnson and NJMS SCC and pulmonary critical care programs delivered every other week on Thursdays

5. “Senior Series” led by the Vice Chair of Education, Dr. Nell Maloney Patel, with lectures aimed at transitioning fellows to practice delivered monthly

6. “Department of Surgery Grand Rounds” conference delivered weekly

Quality Improvement:

1. Dedicated quality improvement monthly conferences for each Acute Care Surgery subspecialty - trauma, emergency general surgery, and surgical critical care

2. Weekly Department of Surgery morbidity & mortality conference 

3. Writing and revision of SICU, trauma and EGS practice management guidelines 

The Rutgers Acute Care Surgery Research (RASR) Lab is powered by 8 ACS principle investigators who provide robust research and mentorship through clinical outcomes, basic and translational science, global health, surgical education, artificial intelligence, and surgical innovation investigations. RASR’s mission is to advance the science of trauma, emergency general surgery and critical care through innovation, collaboration, and rigorous investigation to improve patient outcomes, while educating fellow trainees in the research process. Since 2022, RASR has been awarded over $7 million dollars in funding and has demonstrated tremendous scholarly productivity. RASR investigators maintain strong representation and leadership across national and international societies including EAST, AAST, ACS, SCCM, SUS, AAS, AWS, SIS, SCCPDS, and global surgery organizations.

Prior RWJMS Fellows and their Immediate Post-Fellowship Position

Rachel L. Choron, MD, FACS, FCCM

Associate Professor of Surgery
Medical Director of the Shock Trauma ICU
Program Director of the Surgical Critical Care Fellowship
Director of the Rutgers Acute Care Surgery Research (RASR) Lab
Email: rc1147@rwjms.rutgers.edu

Mayur Narayan, MD, MPH, MBA, MHPE, FACS, FCCM, FICS, FACT, FAIM, FSIS FASE, MAMSE

Chief, Division of Acute Care Surgery
Professor of Surgery
Trauma Medical Director 
Program Director of the Acute Care Surgery Fellowship
Director of Project AiCCESS (Artificial Intelligence for Comprehensive Care, Equity and Sustainability in Surgery)
Executive Director of Rutgers Acute Care Surgery Research (RASR) Lab
Email: mayur.narayan@rutgers.edu

Stephanie Vasquez 

Fellowship Coordinator, Surgical Critical Care and Acute Care Surgery