Training and Curriculum

The Critical Care Medicine Anesthesiology Fellowship offers four approved positions.

Educational Goals and Learning Objectives

The fellowship consists of 13 four-week blocks of clinical and didactic teaching.

RICU = Respiratory Intensive Care Unit
ID = Infectious Disease
TEE = Transesophageal Echocardiography
TTE = Transthoracic Echocardiogram
CSICU = Cardiac Surgery Intensive Care Unit
SICU = Surgical Intensive Care Unit
NSICU = Neurosurgery Intensive Care Unit
PICU = Pediatric Intensive Care Unit
NICU = Neonatal Intensive Care Unit
Research = Four weeks (20 working days distributed throughout the year during CSICU rotations)

Clinical Curriculum

Fellows in the Critical Care Medicine Anesthesiology Fellowship will gain significant clinical experience that provides direct clinical care of intensive care unit patients and supervisory experience. At least half of the minimum required case numbers will be obtained with the fellow as the primary intensivist provider, under the supervision of a faculty member. Supervision of residents and/or other providers by the fellow will be under the direct supervision of a faculty member. The goal of having fellows teach and supervise residents and medical students is to prepare fellows to become faculty supervisors and teachers.

Clinical Training Details

Minimum of Nine and One-Half Months Critical Care Activity

During the 12-month (13-block) fellowship, most of the fellows' time will be spent working with adult critically ill patients. These cases will involve postcardiac, vascular and thoracic surgeries (including major thoracoabdominal aneurysm and mechanical circulatory assist devices), in addition to transplantation procedures (cardiac, lung, liver, renal, pancreas) and surgical critical care patients, including multiple traumas, spinal cord injury, brain injury or other neurologic insults.

Clinical experiences include Cardiac Surgery Intensive Care Unit (24 beds), Surgical Intensive Care Unit (24 beds), Neurosurgery Intensive Care Unit (12 beds), Pediatric Intensive Care Unit (12 beds) and Neonatal Intensive Care Unit (12 beds), Respiratory Intensive Care Unit (12 beds) and transesophageal echocardiography. Other responsibilities include supervising and teaching residents and senior medical students and acting as a liaison between the critical care service and other clinical services involved in the care of various critically ill patients.

Elective 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 and desires.

Features of the Echocardiography Rotation

  • Two to four weeks in cardiology echo lab involving a 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 simulator

Additional Required Clinical Experience Within the Full One-Year Fellowship

  • Respiratory intensive care unit: Management of respiratory failure, pneumonia and acute respiratory disease syndrome, chronic obstructive pulmonary disease, asthma, deep vein thrombosis and pulmonary embolism, poisonings and intoxications. Gain additional experience in infectious disease issues in critical care.
  • Nephrology: Understanding of renal physiology and dysfunction, renal failure (chronic and acute), peritoneal dialysis, intermittent and continuous hemodialysis and ultrafiltration.
  • Infectious disease: Diagnosis and management of infectious diseases, especially in the immunosuppressed patient. Gain additional understanding of culture and isolation techniques and interpretation, nosocomial infections, antibiotic resistance, dosing and drug interactions.
  • Pulmonary mechanics, mechanical ventilation and respiratory care: Pulmonary function testing, bedside assessment of pulmonary mechanics, metabolic assessments, techniques of invasive and noninvasive mechanical ventilation and management of chronic ventilator dependence.
  • Pulmonary and transplant medicine: Assessment and management of severe pulmonary diseases, perioperative management of patients undergoing lung transplantation, and immunosuppressed states.

Research and Other Well-Defined Scholarly Activity

The fellowship offers significant opportunities for fellows 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. Research skills are taught in the curriculum during regular seminars to discuss specific research topics, including study design, institutional review board proposals, statistical modeling, data analysis and abstract/paper writing. Fellows are scheduled for protected research time throughout the duration of the program

Scholarly Activities

Fellows must participate actively in scholarly activities related to critical care medicine anesthesiology. 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