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Trauma Anesthesiology Fellowship Program

Message from the Program Director

‌The mission of the R Adams Cowley Shock Trauma Division of Trauma Anesthesiology is to provide anesthesia expertise for the resuscitation and perioperative care of every critically injured patient at the trauma center. The Division of Trauma Anesthesiology is one of the only groups of anesthesiologists in the country with a practice focused specifically on traumatic injury, personally seeing each admission to the trauma bay on patient arrival. Our clinical practice incorporates acute pain management, regional anesthesia, intensive care medicine, echocardiography and long-term follow up care of patients after injury. Fellow rotations may also include pre-hospital ground and air retrieval, Multitrauma and Neurotrauma ICU coverage, and Trauma Radiology, Focused Assessment with Sonography in Trauma.

An anesthesiologist is present at every patient's admission to the Shock Trauma Center to assess and manage the airway, and to facilitate early pain control. Venous access, transfusion and acute resuscitation may also be initiated. An Attending Anesthesiologist is available in-house 24 hours a day for emergency airway management in the ICUs, for conscious sedation procedures, for bedside procedures on ECMO patients, and for comprehensive perioperative care in the TRU, OR, and PACU. All of the surgeons at Shock Trauma are specifically trained in trauma (e.g. surgery, orthopedics), as are the nurses and the technicians.

The Division of Trauma Anesthesiology includes 14 full-time attending anesthesiologists (5 with additional board certification in critical care, 2 cardiac anesthesiologists, the Director of Regional Anesthesia at the University of Maryland, 2 United States Air Force (USAF) anesthesiologists and 2 part-time anesthesiologists, along with 25 CRNAs, performing more than 6,000 anesthetics each year. We enjoy a collaborative practice with all specialties at the trauma center due to our singular focus: rescue of the patient from the brink of death and restoration to a meaningful, productive life.

We welcome your interest in our training program and look forward to meeting you.

Justin Richards, MD, Assistant Professor, Program Director View Profile

Learn More about the Trauma Anesthesiology Fellowship Program

Education

In the 1980's, Shock Trauma began the first Fellowship in Trauma Anesthesia in the U.S. Our fellows are U.S. civilian and U.K. military clinicians, and the Division also trains 25 to 30 anesthesia residents each year, rotating in one-month blocks from the University of Maryland, the armed services, and visiting residents from across the country. Forty eight residents in emergency medicine and fellows in pulmonary/critical care and trauma surgery/critical care also gain their airway training through us. In addition, we are responsible for the annual training of 50 Maryland State Police flight paramedics and for 50 student nurse anesthetists. Finally, representatives of the Division also train and supervise the nurses of the Acute Pain Management Service, providing advanced pain management modalities for more than 1500 patients each year.

Anesthesiologists from the Division teach University of Maryland medical students in a “hands-on” airway management course in the third year, and again as they rotate through the STC during their anesthesia training. The exposure that paramedics, nurses, medical students, residents, fellows and the military gain at Shock Trauma to severely traumatized airways and to emergency management of the airway ensures that each patient these providers treat in the future will undergo the best possible care.

The USAF and the University of Maryland have a long standing partnership to integrate active duty anesthesiologists and CRNAs into the Division of Trauma Anesthesiology. While stationed at the USAF's Center for the Sustainment of Trauma and Readiness Skills (C-STARS), Baltimore, the active duty anesthesiologists and CRNAs are embedded with the civilian faculty. Working side-by-side with the expert civilian Anesthesia staff, the military personnel gain the critical clinical experience and academic support while learning from the world's leaders in anesthesia and resuscitation. This partnership allows the USAF to train over 300 medical personnel from bases around the world, translating into vital airway, anesthesia and resuscitation management for our injured and ill wounded warriors.

Simulation Training

Simulation training is an integral part of our educational program.  A monthly simulation course of high risk challenging scenarios, conducted in a 10,000 square foot state-of-the-art Simulation Center, is taught by the faculty to airway and anesthesia rotators.  From the control room, faculty observe participants and discuss lessons during post-simulation debrief meetings.  Fellows are involved initially as participants in the simulation course and are transitioned to teaching roles to become leaders in trauma medicine. 

Research Training

The discovery and promulgation of new and better ways of caring for injured patients is a core tenant of the Shock Trauma Center. Research endeavors of the Division of Trauma Anesthesiology include studies of airway management techniques and protocols, anesthetic drug selection, advanced resuscitation techniques for patients in hemorrhagic shock, and non-surgical approaches to hemostasis. Ongoing IRB-approved studies that our faculty lead are investigating pre-hospital resuscitation and transport; trauma team dynamics; multiple-organ failure in damage control orthopedic patients; predictors of chronic pain in patients after orthopedic trauma; and long term physical, emotional and financial needs of patients after injury. Our anesthesiologists are critical to the management of patients with retrograde endovascular balloon occlusion of the aorta (REBOA) and those enrolled in the NIH-funded Emergency Preservation Resuscitation (EPR) trial. In the field of intensive care medicine, members of the Division have presented and published work on advanced ventilator management, continuous renal replacement therapies, transesophageal echocardiography, and extra-corporeal circulation. The Anesthesiologists and CRNAs of the Division are the acknowledged national experts on anesthesia for trauma care, are sought out for textbook chapters, review papers and research publications in the Anesthesia, Surgical, and Critical Care arenas, and serve as invited speakers at local, national, and international conferences on a regular basis.

Fellowship Alumni

Our alumni go on to take prominent positions as division directors, national and international leaders in trauma education, ASA committee members and chairpeople, Board of Directors members, and trauma anesthesiology consultants.

 

Recent Publications

Zhu TH, Hollister L, Opoku D, Galvagno SM Jr. Improved Survival for Rural Trauma Patients Transported by Helicopter to a Verified Trauma Center: A Propensity Score Analysis. Acad Emerg Med. 2018;25(1):44-53.

Gerstein NS, Sanders JC, McCunn M, Brierley JK, Gerstein WH, West SD, Tawil I, Kraai EP, Boyd NH, Bronshteyn YS, Torgeson EL, Schulman PM. The Gun Violence Epidemic: Time for Perioperative Physicians to Act. Journal of Cardiothoracic and Vascular Anesthesia. 2018;(3):1097-1100. 

Galvagno SM Jr, Mabry RL, Maddry J, Kharod CU, Walrath BD, Powell E, Shackelford S. Measuring US Army medical evacuation: Metrics for performance improvement. J Trauma Acute Care Surg. 2018;84(1):150-156.

Mazzeffi M, Tanaka K, Galvagno S. Red Blood Cell Transfusion and Surgical Site Infection After Colon Resection Surgery: A Cohort Study. Anesth Analg. 2017;125(4):1316-1321.

Galvagno SM Jr, Fox EE, Appana SN, Baraniuk S, Bosarge PL, Bulger EM, Callcut RA, Cotton BA, Goodman M, Inaba K, O’Keeffe T, Schreiber MA, Wade CE, Scalea TM, Holcomb JB, Stein DM, on behalf of the PROPPR Study Group. Outcomes after concomitant traumatic brain injury and hemorrhagic shock: A secondary analysis from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios trial. J Trauma Acute Care Surg. 2017;83(4):668-674.

Conti BMFouché-Weber LYRichards JEGrissom T. Images in Anesthesiology: Video Laryngoscopy for Intubation after Smoke Inhalation. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2017;127(4):709-709.

Conti BMRichards JE, Kundi R, Nascone J, Scalea TM, McCunn M. Resuscitative Endovascular Balloon Occlusion of the Aorta and the Anesthesiologist: A Case Report and Literature Review. A&A Practice. 2017;9(5):154-157.

Kaslow O, Kuza CM, McCunn M, Dagal A, Hagberg CA, McIsaac JH 3rd, Mangunta VR, Urman RD, Fox CA, Varon AJ. Trauma Anesthesiology as Part of the Core Anesthesiology Residency Program Training: Expert Opinion of the American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness (ASA COTEP). Anesth Analg. 2017;125(3):1060-1065.

Grissom TERichards JE, Herr DL. Critical Care Management of the Potential Organ Donor. Int Anesthesiol Clin. 2017;55(2):18-41.

Conti B, Greco KM, McCunn M. The Acute Care Anesthesiologist as Resuscitationist. Int Anesthesiol Clin. 2017;55(3):109-116.

Research

Members of the Trauma Anesthesia faculty have been widely published. For example, published research areas have focused on resuscitation, evaluation of non-anesthesia airway trainees and traumatic brain injuries. Shock Trauma Center participated in a large multicenter research project known as the PROPPR study. This study investigated different ratios of blood products to control hemorrhage in trauma patients and the influence on long-term outcomes, such as survival and post-operative complications. Faculty are currently involved in a variety of projects such as assessing non-invasive monitors to assist pre-hospital providers with triage decisions or interdepartmental studies investigating oxygen concentration and outcomes in orthopedic patients. We are currently participating in a multicenter prospective trial of using circulatory arrest and deep hypothermia to facilitate timely surgical repair in patients who have sustained life threatening penetrating trauma.

Recent Publications

Vadlamani A, Perry JA, McCunn M, Stein DM, Albrecht JS. Racial Differences in Discharge Location After a Traumatic Brain Injury Among Older Adults. Arch Phys Med Rehabil. April 2019. PMID:30954440.

Galvagno SM Jr, Nahmias JT, Young DA. Advanced Trauma Life Support® Update 2019: Management and Applications for Adults and Special Populations. Anesthesiol Clin. 2019;37(1):13-32. PMID:30711226.

Matsushima K, Conti B, Chauhan R, Inaba K, Dutton RP. Novel Methods for Hemorrhage Control: Resuscitative Endovascular Balloon Occlusion of the Aorta and Emergency Preservation and Resuscitation. Anesthesiol Clin. 2019;37(1):171-182. PMID:30711230.

Galvagno SM Jr, Massey M, Bouzat P, Vesselinov R, Levy MJ, Millin MG, Stein DM, Scalea TM, Hirshon JM. Correlation Between the Revised Trauma Score and Injury Severity Score: Implications for Prehospital Trauma Triage. Prehosp Emerg Care. 2019;23(2):263-270. PMID:30118369.

McCunn M, Ahmed MI, Kuza CM. Modern Day Trauma Care for the Anesthesiologist. Anesthesiol Clin. 2019;37(1):xv - xvi. PMID:30711238.

Aarabi B, Olexa J, Chryssikos T, Galvagno SM, et al. Extent of Spinal Cord Decompression in Motor Complete (American Spinal Injury Association Impairment Scale Grades A and B) Traumatic Spinal Cord Injury Patients: Post-Operative Magnetic Resonance Imaging Analysis of Standard Operative Approaches. J Neurotrauma. 2019;36(6):862-876. PMID:30215287.

Slade IR, Samet RE. Regional Anesthesia and Analgesia for Acute Trauma Patients. Anesthesiol Clin. 2018;36(3):431-454. PMID:30092939.

Drumheller BC, Basel A, Adnan S, Rabin J, Pasley JD, Brocker J, Galvagno SM Jr. Comparison of a novel, endoscopic chest tube insertion technique versus the standard, open technique performed by novice users in a human cadaver model: a randomized, crossover, assessor-blinded study. Scand J Trauma Resusc Emerg Med. 2018;26(1):110. PMID:30587216.

Richards JE, Conti BM, Grissom TE. Care of the Severely Injured Orthopedic Trauma Patient: Considerations for Initial Management, Operative Timing, and Ongoing Resuscitation. Adv Anesth. 2018;36(1):1-22. PMID:30414633.

Manzano-Nunez R, Escobar-Vidarte MF, Orlas CP, Galvagno SM, et al. Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril. World J Emerg Surg. 2018;13:44. PMID:30258488.

 

How to Apply

Application Resources:

Your file is complete when we receive: 

  1. The completed University of Maryland Application for Fellowship in Anesthesiology. The application must have an original signature. 
  2. Current curriculum vitae
  3. Your Personal Statement (name and credentials should appear on the personal statement)
  4. A copy of your medical school transcript
  5. Your USMLE I, II & III /COMLEX scores
  6. Your specialty specific In-Service, In-Training exam or Board Scores
  7. Three letters of reference; one of which should be from the chairman or program director of your training program

All documents (items 1-6) should be submitted and received in full.  

All Letters of Recommendation should be sent directly from the respective writer, unless the LORs are in a sealed envelope with their signature across the back.

Applications and LORs can be sent by postal mail or courier to: 

Justin Richards, MD, Trauma Fellowship Program Director
c/o Residency & Fellowship Program Coordinator
Department of Anesthesiology
University of Maryland Medical Center
22 South Greene Street, Suite S11C00
Baltimore, Maryland 21201

Phone: 410-328-2628

Fax: 410-328-0546

Electronic submissions should be should be sent to: anesresfellcoor@som.umaryland.edu