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SPECIFIC TRAINING PROGRAMS

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Training - National Institutes of Health (NIH)

 

Shriners Burn Hospital in Galveston

Clinical and Clinical Research Burn Fellowship

Program Description

   We are presenting a 2-year training program, which begins with one year of clinical research and continues with a second year of clinical work.

   Thermal injury remains a major medical problem throughout the world.  Although many advances have been made, there are numerous unresolved questions concerning the nature and treatment of this injury.  To gain new knowledge and to make it available to the general population of clinicians caring for burned patients, trained specialized burn physicians are needed.  Besides their clinical skills these clinical researchers should also have the ability to interpret new findings, test hypotheses in a clinical setting and then relate then to fellow physicians in a scientific manner.  The objective of this program is to train such individuals.  It is hoped that this will ultimately lead to the dissemination of new knowledge for the care of thermally injured patients.

   The Shriners Burn Hospital in Galveston is a teaching center for burn care and burn care research.  The program is integrated into The University of Texas Medical Branch and encompasses a large interdisciplinary team.  This team conducts a multi-million dollar research program, which investigates thermal injury and other areas of related pathophysiology.

   The basic didactic core covers courses in various disciplines.  These include statistics, ethics and scientific writing.  There is a weekly interdisciplinary lecture series in which the fellows present lectures on topics related to burns, sepsis and trauma.  At these presentations the faculty are in attendance to help the candidates develop their skills as lecturers.  In a twice-weekly meeting the various research programs are discussed and the faculty and fellows present their current research efforts and plan their next week's program.  Weekly Morbidity & Mortality Conferences in Anesthesiology & Surgery and Surgical Grand Rounds are held.
 

First Year, Clinical Research

   The fellow will be educated in the conducting of clinical studies on the burn units.  These studies are planned, designed and conducted in collaboration with the Division of Metabolism at the Shriners Burn Hospital.  The patients on the burn units are involved in these clinical studies.  To perform the studies the patients are followed from the time of arrival throughout their entire hospital stay and on their return visits to the outpatient clinic.

Each study involves the following :

-  Screening of patients before the study.
-  Placement of lines.
-  Monitoring the patients during the study.
-  Biopsies.
-  Follow-up after the study.
-  Processing of samples.
-  Analysis of data.

   At the end of the year of clinical research the fellow should have gained knowledge in the planning of research projects and should be able to analyze and present scientific data.  In this year the fellow will be trained to be able to write full-length scientific publications and to present the abstracts at national meetings.  This work can be continued during the second year at the Shriners Burn Hospital.  At the same time the fellow can gain insight into the care of patients on the unit and thus prepare for the clinical year.
 

Second Year, Clinical Work

   The fellow supervises the Intensive Care Unit at the Shriners Burn Hospital, which has 15 beds and the 8-bed adult Burn Intensive Care Unit at The University of Texas Medical Branch.  Additionally, patients involved in the day-surgery program and patients who are re-admitted for reconstructive procedures after their acute hospitalization are treated.

The clinical work comprises the following :

-  Acute burn care of newly admitted patients.
-  Planning and performance of surgery on burn patients.
-  Intensive medical treatment of burn patients.
-  Participation in the twice-daily teaching rounds on the units.
-  Training of surgical residents and medical students who rotate to the unit.
-  Interaction with the clinical research team.
-  Interaction with other disciplines in treating the patients, e.g. Physical Therapy, Clinical Psychology.
-  Care for the patients seen in the outpatient clinic twice a week.

   In this year the fellow should learn to establish a plan of care for a thermally-injured patient and also acquire the skills needed to then fulfill this plan.  The fellow should be aware of problems and possible pitfalls in the treatment and should be able to avoid these, or else be able to manage them.

   Parallel to the clinical work there is the possibility to continue and complete the research projects begun in the first year.

   The excellent facilities at the Shriners Burns Institute in Galveston, Texas and the generous support provided make the combination of a year of clinical training and a year of research a truly effective and fruitful experience for the young doctors involved.

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