Early impact of dedicated ECMO fellows on program outcomes

Abstract

Background

Utilization of extracorporeal membrane oxygenation (ECMO) has expanded substantially, yet structured training for surgical residents remain limited. We established a dedicated ECMO/mechanical circulatory support (MCS) fellowship for general surgery residents on dedicated academic time and evaluated its feasibility, educational impact, and association with institutional outcomes.

Methods

A single-center retrospective review was performed comparing ECMO activity and outcomes before and after fellowship implementation. . Institutional outcomes were compared across pre-fellowship and fellowship eras. Fellows’ clinical involvement was quantified through procedural logs and self-reported comfort levels. A multidisciplinary survey assessed perceptions of workflow, communication, and education using 5-point Likert scales and free-text feedback.

Results

Two fellows completed the program during the study period. Since initiation, annual ECMO runs increased from 59 to 119 (+101%), with total ECMO hours rising 59%. The proportion of patients successfully weaned from ECMO improved significantly in 2025 compared with 2024 (59% vs 41%, χ² = 6.12, p = 0.013), with a corresponding decline in on-support mortality (22% vs 37%). Two fellows matriculated, each participating in approximately 75 cannulations annually and reporting independent cannulation competency by year-end. Of approximately 70 eligible stakeholders, 30 responded (42%), with most agreeing the fellowship improved ECMO care (90%) and ICU–surgical communication (90%), though fewer endorsed reduced workload (43%). Open-ended feedback emphasized enhanced teamwork and continuity of care.

Conclusions

Early implementation of a dedicated ECMO/MCS fellowship for surgical residents was feasible and associated with increased program volume, improved interdisciplinary communication, and robust trainee experience. Early results suggest potential educational and institutional benefits, warranting longer-term evaluation.

Keywords

extracorporeal membrane oxygenation surgical fellowship ECMO education mechanical circulatory support program outcomes

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