HMC Department of Surgery

Course Overview

Welcome to the Surgical Critical Care Service at Harborview. Over your time here you will manage some of the most complex patients you will ever come across over the course of your career. These patients often have several services involved in their management. These patients are usually admitted under the General Surgery, Vascular, or Thoracic Services, however it is the Surgical Critical Care Service that coordinates their care. Although most of the ICU attendings are surgeons, it is important to note that the scope of the ICU service will be limited to evaluation and management of problems separate and distinct from routine postoperative surgical care. These services include but are not limited to

  • Ventilator management
  • Hemodynamic management
  • Management of coagulopathy
  • Diagnosis and management of nosocomial infection
  • Nutritional support
  • Non-operative management of head injury
  • Venous thromboembolism screening, prophylaxis and treatment
  • Management of renal failure exclusive of dialysis
  • Coordination of subspecialty consultations
  • End-of life care

Medical Student Expectations: 

  • Evaluate and develop management plans for severely ill patients in the ICU.
  • Craft comprehensive admission and progress notes.
  • Describe management of the ventilated patient, including ventilator modes, weaning strategies, and indications for tracheostomy placement.
  • Discuss the evaluation and management of hypovolemic, septic, and cardiogenic shock.
  • Recognize the indications for surgical intervention in the critically ill or trauma patient.
  • Perform technical procedures such as arterial line placement, central line insertion, bronchoalveolar lavage, bedside ultrasound and cardiac output assessment, etc.


Students will be evaluated using the standard University of Washington School of Medicine evaluation form currently used for 4th year surgical electives. Students are expected to arrange a meeting (usually weekly) with the Attending on service to discuss evaluation. It is the student’s responsibility to get this form to each Attending in a timely way to ensure they are completed before the end of rotation. Students will meet with TSICU fellows at the mid-course point for interim feedback.

Visiting Students

This course is 4 weeks, 8 credit- SURG 691 is not offered for more than 4 weeks and cannot be taken twice.

For US and Canadian Medical Students

Please review the guidelines