Early impact of dedicated ECMO fellows on program outcomes

Area of Science:

• Cardiovascular Surgery
• Surgical Education
• Critical Care Medicine

Background:

• Extracorporeal membrane oxygenation (ECMO) utilization has grown, but structured training for surgical residents is limited.
• A dedicated ECMO/mechanical circulatory support (MCS) fellowship was established for general surgery residents.

Purpose of the Study:

• To evaluate the feasibility and educational impact of a dedicated ECMO/MCS fellowship.
• To assess the fellowship's association with institutional ECMO outcomes.

Main Methods:

• Single-center retrospective review comparing ECMO activity and outcomes pre- and post-fellowship implementation.
• Fellows' clinical involvement tracked via procedural logs and self-reported comfort.
• Multidisciplinary survey assessing perceptions of workflow, communication, and education.

Main Results:

• Annual ECMO runs increased by 101%, with total ECMO hours rising 59%.
• Successful ECMO weaning improved (59% vs 41%), and on-support mortality decreased (22% vs 37%).
• Fellows gained independent cannulation competency, and most stakeholders perceived improved ECMO care and communication.

Conclusions:

• A dedicated ECMO/MCS fellowship for surgical residents is feasible and associated with increased program volume.
• The fellowship enhanced interdisciplinary communication and provided robust trainee experience.
• Early results indicate potential educational and institutional benefits, meriting further evaluation.