• Trauma only
• Critical Care only
• Trauma & Critical Care
• Acute Care Surgery
• Advanced Practitioner

• Duration: 1 year
• Positions available: 1
• Salary:
• Program Director: Alicia Privette, MD, FACS

Last updated: February 10, 2025

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Medical University of South Carolina (MUSC) is the tertiary, academic referral center for Eastern South Carolina. We are located in downtown Charleston SC. We are the only Level 1 trauma center serving the entire East Coast of South Carolina, a catchment area of about 1.5 million people, as well as the only Burn Center in the entire state. The medical center has critical care units dedicated to trauma/general surgery/burn, cardiothoracic and vascular surgery, neurosurgery, medicine, cardiology, pediatrics and neonatology.

The South Carolina Burn Center/MUSC Burn Fellowship is centered on the clinical aspects of burn surgery and patient management as outlined by the American Burn Association. The fellowship is also designed for the fellow to develop competency in surgical critical care and follow ACGME/ABS guidelines in training for SCC. At the end of the fellowship, the fellow will be eligible for board certification in SCC and will obtain an institutional certificate of completion of a burn fellowship.

The primary goal of this 1 year fellowship is to train surgeons that are interested in performing patient centered, high-quality burn care. The secondary goal is to produce burn surgeons who do burns as their primary specialty or as a major focus in a career such as acute care surgery or plastic surgery. As such, the fellowship aims to produce well rounded, competent burn surgeons through an intensive one-year fellowship exposing our fellows not only to critical care, but also to all aspects of burn care.

The fellow will develop proficiency in all of the areas below, with an experiential training model based on patient volume, independent study, and an educational curriculum- embedded in a preceptorship/mentorship model. Proficiency will be evaluated every 6 months through the surgical critical care and burn competency committee. Factors considered in each evaluation period include progressive diagnostic and technical proficiency in each of the areas listed below, along with documentation, and systems-based practice. It is expected that progression toward independence as a Burn surgeon or toward a second fellowship year as an instructor of surgery. The curriculum will involve 6 months of surgical ICU management, 3 additional months of ICU care, and 3 elective months. The fellow will participate in burn care for at least 6 months of the fellowship. Sample rotations might include STICU, BICU, PICU, CVICU, MICU, anesthesiology, or plastic surgery.

Overview:

1. Perform coordination, evaluation, and supervision of a burn care system, including prehospital care and transport. Triage and coordination of transfer of burn injured patients, collaboration with referring providers to develop a plan of care.

2. Evaluation, resuscitation, and operative or nonoperative management of critically injured burn patients of all ages.

3. Understand physiology, pathophysiology, diagnosis, and therapy of disorders of the cardiovascular, respiratory, gastrointestinal, genitourinary, neurologic, endocrine, musculoskeletal, and the immune systems after thermal injury.

4. Understand and manage metabolic, nutritional, and endocrine effects of burn illness, including shock, sepsis, and multiple organ failure.

5. Understand burn wound physiology, pathophysiology, diagnosis, and therapy.

6. Become proficient with various monitoring strategies, medical instrumentation of the burn patient- including ultrasound.

7. Understand pharmacokinetics and dynamics of drug metabolism and excretion following thermal injury.

8. Participate in ethical and legal aspects of burn care. Palliative care, end of life and goals of care.

9. Biostatistics and design of studies.

Burn Care Skills
For the comprehensive care of burn patients, the Fellow must have the opportunity to become proficient and demonstrate proficiency in burn care skills that include the following:

1. Burn Shock Resuscitation:
a. Management of acute burn resuscitation, prevention of, and rescue of burn shock.
b. Diagnosis, monitoring and management of dysrhythmias, and all types of shock.
c. Competency in the management of acute kidney injury, metabolic disturbances, and the use of renal replacement therapies.
d. Knowledge of different resuscitation regimens; invasive monitoring techniques using peripheral and central arterial and venous catheters, use of infusion pumps and vasoactive agents in the management of cortical illnesses
e. Recognition of the need for and acquisition of the skills for performance of escharotomies and fasciotomies of the extremities and trunk
f. Management of patients with multiple injuries, including blunt or penetrating trauma.
2. Inhalation Injury/Respiratory Failure:
a. Diagnosis and management of inhalation injury and carbon monoxide poisoning
b. Use of intubation and maintenance of the airway, including tracheostomy
c. Use of the various mechanical ventilators and other devices to support gas exchange, and interpretation of blood gases.
d. Performance of bronchoscopy
e. Management of endotracheal tubes including techniques for weaning from mechanical ventilation; suction techniques; monitoring airway and intrathoracic pressures; interpretation of sputum cultures
f. Management of pneumothorax
3. Nutrition/Metabolic Support:
a. Prevention and management of gastrointestinal bleeding
b. Understanding of the methods for assessing protein and caloric needs
c. Institution of parenteral and enteral nutrition.
4. Wound Care:
a. Estimation of extent and depth of injury
b. Experience with the timing and appropriateness of excision of burn wounds
c. Pros and cons of layered excision vs fascial excisions
d. Mastery of the technique of tangential excision of burn wounds
e. Understanding of the care of burns to special areas, including the hands, face, feet, and perineum
f. Understanding wound management in children and elderly patients
g. Familiarity with different wound coverage options
h. Understanding of the different antibiotic dressings for burn wounds and their indications and contraindications
i. Management of chemical and electrical injuries.
5. Rehabilitation:
a. Understanding the need for early and continuous intervention by burn therapists (occupational and physical) in the recovery of burn patients
b. Understanding the principles of splinting and pressure appliances
c. Understanding of the surgical procedures for contractures, resurfacings, and reconstructions.
6. Infectious Disease:
a. The diagnosis and management of infection and sepsis
b. Techniques of isolation
c. Interpretation of cultures and selection and management of therapy; control of nosocomial infections; and protection of health care providers.
7. Dermatologic Problems:
a. Management of life-threatening dermatologic problems, for example, toxic epidermal necrolysis, epidermolysis bullosa.
8. Psychosocial:
a. Understanding the role of social services, psychologists, and psychiatrists in the management of the burn patient
b. Understanding the psychological stress of the family and patient
c. Understanding child abuse
d. Understanding reentry into society (return to work and return to school).
9. Posthospital Care / Outpatient Care:
a. Understanding care after grafting, including outpatient therapy, splints, and pressure therapy
b. Understanding wound maturation and hypertrophic scarring; management of pain and itching
c. Understanding impairment ratings
d. Dealing with job motivation / retraining and work hardening.
10. Reconstruction and Laser:
a. Understand when and how to best intervene with CO2 laser, IPL, PDL, and surgical reconstruction.
b. Knowledge of basic contracture releases with local tissue, skin grafts, skin substitutes
c. Knowledge of when to consult additional specialists for more advanced reconstructive options.
11. Pediatrics:
a. Understand all of the above issues with a focus in differences/similarities of care paradigms in pediatric burn patients

Program started 2025

How to apply

privetta@musc.edu  - (843) 792-8395 (phone)

Qualifications: Completion of a RRC approved General Surgery Training Program and eligible to sit for the ABS examinations

Applications are available and accepted through the Surgical critical care and Acute care surgery Fellowship Application Service (SAFAS)

Location

96 Jonathan Lucas St
Charleston, SC 29425
Website

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