Program history

The Trauma and Surgical Critical Care Fellowship for Advanced Practice Providers at Intermountain Medical Center started in 2010. Our trauma service model centered around APPs was created back in 1998, and was one of the first surgical services in the country to hire Advanced Practice Clinicians (APCs) Providers (APPs). The progressive role of the APCP at IMC focused on increased responsibility, allowing for a clinical experience at the edges of their scopes of practice.

This tenet has helped us recruit and keep more APPs, maintain a very collegial relationship with other providers, and incorporate APPs into the backbone of our trauma and critical care team. Our APP model has also become a template that has been used by many other services within Intermountain Health.

Our trauma services team

We currently have six core trauma surgeons, who rotate weekly to cover the trauma bays, trauma ICU and floor patients. We also currently have 11 trauma APPs, a mix of both NPs and PAs. We work closely with a team of inpatient neurosurgery and orthopedic surgery APPs as well.

Our research

Our team is actively engaged in trauma and critical care research, led by Dr. Sarah Majercik and the Trauma Research Committee. We perform multiple projects and clinical trials among a variety of areas. We have focused particularly on management of rib fractures and helped pioneer the role of surgical stabilization, massive transfusion protocolization, use of thromboelastography, and venous thromboembolism management in trauma patients.

Fellowship goals

• Provide the highest quality education in order to train exceedingly competent APPs in the specialty of trauma and critical care
• Learn current guidelines and best practices of trauma and critically ill patients
• Obtain procedural skills in traum aand critical care
• Master critical care concepts such as ventilator management, infectious disease, pharmacology and management of the unstable patient
• Master the role of leading a trauma resuscitation and massive transfusion protocol
• Utilize Intermountain Health's strengths and outstanding reputation of promoting best practices as groundwork for education of the APPs
• Develop leaders who will promote the role of APPs in trauma and critical care
• Assist the APP Fellow in gaining a comprehensive understanding and first-hand experience in conducting clinical research
• Continue to work with PA and NP associations to support the current local and national guidelines for each role, which will reinforce autonomy and collaboration of both professions

Our mission

Our mission is to develop high-quality advanced practice providers who excel in trauma and critical care, through practical and rigorous clinical experience, didactic learning, and mentorship from dedicated leaders. We strive to cultivate influential clinicians and leaders who will promote and progress the understanding and expectations of these providers. Over 12 intensive months, our fellows will achieve excellence in clinical competence, invasive and non-invasive bedside procedures, harm prevention, leadership, and research methods in trauma and critical care.

How to apply

Applicants will apply on the Intermountain Healthcare Jobs and Careers portal. ANTICIPATED JOB POSTING IS APRIL 1st EACH YEAR. To be considered for acceptance, applicants need to submit an online application and the following documents listed below. Please note that DEA and licensure documents can be pending graduation at the time of application and therefore do not need to be submitted with the application. The job is generally posted for 2 weeks, so please be prepared with the required documents (particularly the reference letters) once the position is open, in order to guarantee timely and complete submission. Any incomplete applications by date of closure will not be considered.

• Application (filled out online)
• Copy of curriculum vitae
• Two letters of recommendation
• Personal letter of intent
• Proof of graduation from a PA or NP accredited program
• Proof of Board Certification
• DEA license
• Proof of licensure in the State of Utah as a PA or NP (intern license acceptable)
• Copy of current BLS/ACLS cards

When does selection begin?

Our formal selection process begins in the Spring of each year. The position will be posted to the Intermountain job portal on APRIL 1st each year. The posting is generally up for two weeks, during which time applicants will be allowed to submit applications. Only completed applications will be considered. Please be prepared to submit all required items and complete the video-Q/A portion of the application in a timely manner to ensure a completed application before closure of the position. All subscribers to our mailing list will receive an email update when the position goes live, with a link to the posting. The posting link will also be added to this website page once it becomes available, but there may be a slight delay. Please email the director to ensure you are placed on our group mailing list in order to receive live email notifications and updates regarding the selection process. Invitations for a live virtual interview will be made in early May.

What is the selection process like?

Our selection process is based on complete applications and ideally an in-person interview. Candidate experience and background is varied, and our decision process is fortunately difficult. We receive competitive applications from many high caliber candidates and, as such, closure of enrollment is usually done within two weeks.

The most competitive candidates have an honest and genuine interest in Trauma and Critical Care medicine, and possess leadership skills, and an interest in clinical research. They also understand the rigor and focus that is required to successfully complete this year of hard work, long hours and sacrifice.

The fellows will work under the medical supervision of advanced practice providers and physicians on their respective rotations, and will gain independence as the year progresses. Overnight call shifts will constitute a part of the weekly schedule, in an effort to offer ample opportunity for clinical experience and high acuity patients. Fellows will undergo quarterly evaluations with the program and medical directors.

• Prioritization of patient care, proper documentation, and preparedness for daily patient rounds, ensuring an efficient work flow
• Develop and implement appropriate treatment plans
• Order and interpret appropriate diagnostic testing
• Maintain a self-directed learning approach
• Team lead in all Trauma I and II activations
• Team lead in all hospital-wide Massive Transfusion Response Team activations
• Attend and participate in all didactic components (see below)
• Perform a clinical research project culminating in a presentation at our annual Excellence in Trauma Care Conference, an abstract that meets submission requirements to a chosen journal, and ultimately a manuscript
• Prepare small presentations for Trauma Morning Report or weekly Trauma Grand Rounds as requested
• Completion of Advanced Trauma Life Support course
• Maintain ongoing communication with the Program and Medical Directors

Clinical rotations

• Trauma surgery and critical care
• Acute care surgery
• Pulmonary critical care
• Anesthesia
• Neurosurgery and neurocritical care
• Orthopedic surgery
• Pharmacy
• Ultrasound and radiology
• Pediatric trauma and acute care surgery
• Elective options

Didactic components

• Trauma Morning Report, daily
• Trauma Grand Rounds, weekly
• Trauma Journal Club, every 3 months
• Didactic Trauma and Critical Care Lecture Series, weekly
• Pharmacy Resident Journal Club, weekly
• Morbidity and Mortality conference, monthly
• Emergency Medicine Residency conference, weekly
• One CME conference ($ for travel and fees covered with a specified limit), annually

• Generally fellows will work 6 days per week, including two, 24-hour call-shifts, totaling approximately 64 hours per week
• Didactic time is included and protected (conferences, research and lecture series)
• Schedules will include weekends and holidays
• When rotating on other services, the schedule will vary
• The Fellow will be given 10 days of paid vacation and 3-5 days paid for an annual CME/conference

• Salary: Approx $75,000 per year
• Medical and dental insurance
• Disability insurance
• Malpractice insurance
• CME allowance: $2500
• CME time: 1 conference
• Vacation: 10 days

With regards to your testing, certification, and licensure, the National Commission on Certification of Physician Assistants (NCCPA) provides results quickly — usually within a couple weeks. The State of Utah has a provisional license clause that allows you to practice while you are in the process of obtaining your official license. Intermountain Medical Center provides this same provisional status as well.

However, there must be some flexibility because you cannot officially start until you have your DEA. In years past, we have allowed for flexible start dates based on this bottleneck.