Curriculum & Training
Fellows gain comprehensive experience in all facets of the Critical Care Medicine Anesthesiology Fellowship. The Anesthesiology Critical Care Medicine Fellowship offers four approved positions.
Educational Goals and Learning Objectives
The fellowship consists of 13 four-week blocks of clinical and didactic teaching. Fellows have a choice of two tracks. A traditional critical care medicine fellowship with a focus on cardiothoracic intensive care and a TEE track that allows for fellows to get basic or advanced TEE certification eligibility during the year.
Each track is composed of 40 total weeks of intensive care unit rotations, including the cardiothoracic surgical ICU, surgical ICU, neurosurgical ICU, pediatric/neonatal ICU and medical ICU. All fellows receive a dedicated month of echo, which includes TEE, TTE and Point-of-Care Ultrasound training.
Both tracks include four weeks of electives which are tailored to the fellow's interests but have included infectious disease, nephrology, cardiology. Fellows that choose the TEE track have the option to use their elective rotation for additional echo training.
Fellows also may take up to 20 working days for research, and there are 4 weeks of vacation during the year.
During the 12-month (13 blocks) fellowship, most of the time will be spent working with adult critically ill patients. These cases will involve post-cardiac, vascular and thoracic surgeries (including major thoraco-abdominal aneurysm and mechanical circulatory assist devices), in addition to transplantation procedures (cardiac, lung, liver, renal, pancreas) and surgical critical care patients, including multiple trauma, spinal cord injury, brain injury or other neurologic insults.
Required clinical rotations:
- Cardiac Surgery Intensive Care Unit (24 beds) patients admitted both post and pre-operatively. The faculty are core faculty of the program from Anesthesiology, Pulmonary Critical Care and Surgery. We have a high cardiac transplant volume, as such patients are complex and often supported with mechanical devices. The rotation also has a heavy educational component of point of care ultrasound with a didactic and practical component.
- Surgical Intensive Care Unit (24 beds) patients admitted both post and pre-operatively including high volume liver transplantation program and trauma surgical program. Fellows work with surgical residents and fellows under the surgical trauma critical care attendings.
- Neurosurgery Intensive Care Unit (12 beds) patients include neurologic emergencies, postneurosurgical patients and neuro interventional. Faculty are neuro-critical care and fellows interact with a variety of other fellows
- Pediatric Intensive Care Unit (12 beds) and Neonatal Intensive Care Unit (12 beds)–Pediatric patients under the training of pediatric critical care attendings.
- Medical Intensive Care Unit (12 beds) patients with a variety of medical conditions, coverage is 100 percent pulmonary critical care faculty.
These rotations on other clinical services pertinent to critical care medicine are available. The elective component of the fellowship is flexible and will be tailored to meet the educational needs of individual applicants and, wherever possible, their particular interests. These electives include but are not limited to nephrology, infectious disease, interventional pulmonary, ultrasound and echocardiography.
Features of the echocardiography rotation include:
- Two to four weeks in cardiology echo lab involving significant practical experience in transthoracic echocardiography and TEE simulation
- Up to four weeks of perioperative TEE, with supervision of exam performance and interpretation and over-reading of reports (electives)
- Reality-based structured training using a TEE and TTE simulator
Point-of-Care Ultrasound (POCUS) Training:
Critical care medicine fellows will participate in a longitudinal POCUS training program over the span of their fellowship year. This program includes faculty-led POCUS didactics, simulations and online modules as well as opportunities to apply acquired skills during patient care on rotations.
In addition to bedside teaching and clinical experience, fellows will participate in:
- Monthly CSICU faculty lead journal club
- Weekly SICU Journal Club
- Weekly faculty lectures in CSICU and in SICU
- Weekly echo conference
- Monthly CSICU M and M conference
- Research seminars to discuss specific research topics, including study design, IRB proposals, statistical modeling, data analysis and abstract/paper writing; fellows are scheduled for protected research time throughout the duration of the program
The program offers fellows the opportunity to participate in scholarly activities. Each fellow is required to participate in a yearlong critical care research project with the goal of completing at least one project initiated during fellowship training.
Fellows must participate actively in scholarly activities related to anesthesiology critical care medicine. Each fellow must also be engaged in a quality improvement project. Each fellow must complete a minimum of one academic assignment. Academic projects may include the following:
- Grand rounds presentations
- Case reports
- Preparation and publication of review articles
- Book chapters
- Manuals for teaching or clinical practice
- Clinical track research investigation
- Basic science research investigation
- Other projects