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 service s. We surveyed all chief residents who finished in the past 10 years, comparing the 5 years before the linking of trauma and critical care t o the period since. Between 1982 and 1987, 3 of the 45 finishing resid ents (7%) pursued trauma fellowships, then trauma care as a career. Si nce 1987, 12 finishing residents (30% of the total and 33% of those pu rsuing fellowship training) trained in trauma/critical care. Nine curr ently pursue trauma care as a career. Two others are academic trauma s urgeons without fellowship training and one other practices general su rgery with trauma care as a main focus. Thus 12 of the 41 residents (3 0%) practice trauma care and 14 residents (34%) practice critical care . Residents finishing since 1987 were significantly more likely to res pond that they are interested in trauma care, feel trauma care was att ractive, and wish to have trauma care be a major portion of their care ers. Those who chose not to pursue trauma care cited reasons similar t o those described by Richardson and Miller. Other specialty interests were the most important factor in both time periods. Residents finishi ng after 1987 described the link between trauma care and critical care with a designated ICU service as strong positive influences. The unde rstanding of resuscitation physiology gained in the ICU, including non surgical therapy, was felt to enhance trauma care, making it more attr active. In our system, trauma/critical care attending physicians were perceived as important role models. Critical care training enhances th e trauma care experience. It is an important educational tool and make s trauma care more attractive as a career.