Undersea & Hyperbaric Medicine Fellowship program facts

The Aurora Health Care Undersea and Hyperbaric Medicine Fellowship Program is a one-year, ACGME-accredited training program with two fellowship positions per year.

We have 14 hyperbaric programs in our hospital system, two of which are training sites. Our primary teaching center is at our multi-place hyperbaric facility located at Aurora St. Luke’s Medical Center in Milwaukee. Our secondary teaching site offers monoplace hyperbaric training, which is located at our Kenosha medical center.

Fellows in the program can expect to see clinical cases involving the full spectrum of hyperbaric and undersea medicine indications, including those of an emergent and critical nature. Fellows will also take call with our overnight emergent team.

In addition, fellows will gain experience in wound care and can expect to be a part of our multidisciplinary limb salvage teams.

We have multiple board-certified fellowship trained attendings on our core faculty, who have created a comprehensive curriculum and didactic series for the training year. Our fellows will also attend out-of-state continuing medical education (CME) training courses as part of their fellowship experience.

Curriculum

The fellowship goal is to produce physicians who are able to achieve competencies for both the multi-place and monoplace training sites. At the end of training, fellows will be able to function as a future leaders and independent physicians in the field of Hyperbaric and Undersea Medicine.

As fellows become more competent, they will be given more autonomy in their medical decision making and supervision of residents and medical students. At the completion of their training, they will also be board eligible.

At the completion of the fellowship, fellows will demonstrate a cognitive understanding of: the history of hyperbaric medicine; hyperbaric treatment primary and secondary effects; pathophysiology and understanding of laws of physics (gas laws) with regard to mechanism of action; risks and benefits of hyperbaric treatment; relative and absolute contraindications of hyperbaric treatment; criteria for each emergent and non-emergent indication of hyperbaric treatment; ability to screen and examine a patient for hyperbaric treatment; and treatment course decisions for patients using on evidence-based medicine.

Objectives include the understanding of:

Pre- and post-hyperbaric treatment evaluation
Management of hyperbaric oxygen treatment side effects
Emergent procedures related to hyperbaric treatment, such as needle decompression for tension pneumothorax
Myringotomy for barotrauma
Appropriate management of an emergent ascent
Management of hypoglycemia, oxygen-induced seizure, and identification and management of pulmonary edema
Hyperbaric treatment tables
Protocols based on the indication that is being treated
Post-hyperbaric treatment patient education and appropriate follow up recommendations
Environmental differences and safety concerns based on those differences for different types of hyperbaric chambers (multi-place vs. monoplace)

Fellows will be given teachings on how to operate the chambers and understand safety protocols in the event of a hazard, such as a fire.

Objectives specific to Undersea Medicine include:

Cognitive understanding of dive-related injuries and illness and appropriate management decisions to care for these conditions (including decompression illness, decompression sickness type I, II, and III, immersion pulmonary edema, pulmonary chokes, marine hazards and poisons)
Demonstrated ability to screen and perform a history and physical for a diving medical examination

The fellows will also have the opportunity to engage in a research related activity involving a topic that is related to the field of hyperbaric and undersea medicine. Fellows will participate in regularly scheduled scholarly activities, such as journal club, hyperbaric patient round discussions, monthly diving conferences and other didactics.

Progression of responsibilities

At the beginning of the training year, the fellow will observe and assist the on-call hyperbaric attending physician with emergent HBOT cases. As the fellow physician experience with emergent hyperbaric cases increases, they will be given more autonomy throughout the year with a goal of progressing to managing the case under supervision by overseeing attending physician to provide insight and guidance as needed.

Progression of evaluation

As the fellow progresses and increases their responsibilities with call, they will receive feedback by the attendings they work with. Also, during their meetings with the program director throughout the year for evaluation of progression, this will be included in the feedback.

Rotations

Clinical training sites are located in Milwaukee and Kenosha. Fellows participate in most cases and typically exceed the case volume requirements of the ACGME.

Rotations include:

Wound Care Clinic
Inpatient Wound Care
Hyperbaric Oxygen Therapy
Limb Salvage Program

Meetings and conferences

The Aurora Health Care Undersea and Hyperbaric Medicine Fellowship offers multiple educational conferences with strong faculty participation. Fellows are encouraged present at the annual Undersea and Hyperbaric Medical Society (UHMS) national scientific meetings.

Didactics include:

Daily Team Huddle
Hyperbaric Medicine Grand Rounds
Friday Bi-weekly Didactic Session
Monthly Duke Dive Conference
ATMO Hyperbaric Medicine Team Training and Wound Care Course (July)
UHMS Physicians Training in Diving Medicine

Salary & benefits

The Aurora Undersea and Hyperbaric Medicine Fellowship offers a competitive salary, comprehensive health coverage for you and your eligible dependents and many other perks.

Salary & benefits overview [PDF]

Apply to the fellowship

Learn how to apply to the Aurora Undersea and Hyperbaric Medicine Fellowship program. Get information about candidate requirements and the application process.

Apply to the Aurora Undersea and Hyperbaric Medicine Fellowship program