Critical Care Medicine Anesthesiology Fellowship

Program Overview

The Critical Care Medicine Anesthesiology Fellowship program at Cedars-Sinai is accredited by the Accreditation Council for Graduate Medical Education. Cedars-Sinai Department of Anesthesiology has a history of commitment to education, research and state-of-the-art clinical practice. Fellows are taught and supervised by faculty representing a cross-section of graduates of the nation's elite anesthesiology programs.

The volume, complexity and severity of illnesses in critically ill patients at Cedars-Sinai, and the number of innovative approaches for treating them, present clinical challenges to the critical care medicine physician. It is our hope that during their time with us, fellows will not only grow in clinical ability and knowledge but also develop their professional and interpersonal skills, as well as the confidence to perform as effective consultants in critical care medicine.

The Critical Care Medicine Anesthesiology Fellowship provides advanced training in the critical care medicine subspecialty. The fellows rotate through a number of specialty intensive care units (ICU) including neuro ICU, surgical ICU, cardiac surgical ICU, pediatric ICU and neonatal ICU. Experience is also available in respiratory ICU and medical ICU. A number of electives are available to enrich the educational experience, including echocardiography.

The fellowship's emphasis includes clinical sciences and scholarly activity designed to accomplish the following:

  • Promote and develop expertise necessary for delivering comprehensive critical care to the ICU patient
  • Promote the acquisition of new knowledge through clinical investigation and study
  • Develop educational skills through supervising residents and teaching in both formal and case-oriented settings


Goals

  • Fellows become familiar with the principles of critical care medicine and their application in managing a full range of clinical problems in a wide array of patients
  • Fellows develop the required competencies needed to provide critical care services to ICU patients
  • Fellows selecting the transesophageal echocardiogram (TEE) track develop the knowledge, skills and attitudes necessary for the safe conduct of perioperative critical care and TEE
  • Fellows learn the practice of critical care medicine in a moral, ethical and professional manner worthy of the Cedars-Sinai model of lifelong professional excellence


Educational Goals and Objectives

Instructional Objectives

Specifically, fellows are required to achieve the following:

  • Become clinically expert in respiratory function; assessment and support of cardiovascular function; management of the neurologically injured patient; perioperative management of end-stage heart failure patients; coagulation disorders; comprehensive management of trauma patients; metabolic support (including electrolyte imbalance, nutritional support, and consequences of organ failure (e.g., liver and kidney); the essentials of infection management and infection control and immunosuppressive regimens.
  • Provide cogent discussions and lectures in critical care, monitoring (including echocardiography) and basics of transplantation.
  • Become proficient in providing and coordinating multispecialty and multidisciplinary critical care delivery through exemplary communication and effective interaction with various disciplines.
  • Become proficient at management of intensive care unit functions including coordinating patient admissions and discharges from ICUs in a multispecialty environment, and development and implementation of guidelines for patient care.
  • Become familiar with the basic components of, and issues pertaining to, clinical research. Fellows are strongly encouraged to develop an individual clinical research project or to participate in any of the ongoing clinical research projects of the critical care section.
  • Become certified in all of the following life support courses. (The Department of Anesthesiology will arrange and pay for all courses.)
    • Basic Life Support
    • Advanced Cardiac Life Support
    • Advanced Trauma Life Support; expected by end of training
    • Pediatric Advanced Life Support; expected by end of training

Technical Objectives

The Critical Care Medicine Anesthesiology Fellowship allows the fellow to attain technical skills in invasive catheter placement and interpretation (e.g., arterial catheters, central venous catheters, pulmonary artery catheter, intermittent catheterization program and transesophageal echocardiography). Upon completion of the program, the fellow will have experience with, as well as critical care management of, adult cardiothoracic, surgical, trauma, neuro, obstetrics/gynecology, pulmonary and transplant patients. The fellow will be familiar with nasal tracheal and double lumen endotracheal insertions, TEE, pacemaker, automated implantable cardioverter-defibrillator, intra-aortic balloon pump counter pulsation, extracorporeal membrane oxygenation, left-ventricular assist device, right-ventricular assist device, bi-ventricular assist device and total artificial heart, along with their respective indications and complications.