The UCSF Fresno ACS fellowship is a 2-year program with a robust experience at the only Level 1 trauma center in Central California. The trauma registry adds 4000 patients annually with 25% going directly to the OR or ICU. The goal of the fellowship is to train independent Acute Care Surgeons, who will function well in the collaborative multidisciplinary SICU and trauma environment and are equipped for leadership positions in these areas.