Highlights
– Limited exposure to surgical intensivists and EM-designed SCC fellowships during residency is common and correlates with low matriculation into surgical critical care (SCC).
– Trainees prioritize intellectual appeal of critical care and specific fellowship components (core CC knowledge, institutional respect for EM-CC, ECMO experience) over board-certification ease.
– Geography, specialty unit exposure, and multidisciplinary team interactions are modifiable determinants of pathway choice; multifaceted interventions at society, institutional, and program levels are indicated.
