The ABA-American Board of Anesthesiology-certifies physicians in critical care medicine by administering the Critical Care Medicine examination. Our fellowship program expects fellows to become certified in Critical Care Medicine.

The critical care medicine physician is a specialist whose knowledge is of necessity broad, involving all aspects of management of the critically ill patient, and whose primary base of operation is the intensive care unit (ICU). This physician has completed training in a primary specialty and has received additional training in critical care medicine aspects of many disciplines. This background enables the physician to work in concert with the various specialists on the patient care team in the ICU; to utilize recognized techniques for vital support; to teach other physicians, nurses and health professionals the practice of intensive care; and to foster research.

Subspecialty certification is detailed in the ABA's BOI (Booklet of Information).

Core Intensive Care Unit Rotations

Nine months of the year-long fellowship are spent in the Surgical and Neurosciences Intensive Care Unit (SNICU) and Cardiovascular Intensive Care Unit (CVICU). The SNICU has four bays with a total of 30 beds and the CVICU (which is a mixed medical and surgical unit) will usually have 6-8 covered beds, depending on surgical census. Four teams cover the SNICU/CVICU (three based in the SNICU, one based in the CVICU). Fellows will rotate on an equal basis among the four teams, generally spending 2-4 weeks at a time with each team.

Elective Rotations

Up to three months may be spent in elective rotations relevant to critical care medicine. The two most popular electives are Echocardiography and Bronchoscopy. Other possible electives include, but are not limited to, Infectious Disease, Neurology, Nephrology, Medical Intensive Care, Pediatric Intensive Care, OR Anesthesia, Burn Surgery, and Research. Novel electives based on a fellow’s particular interests can be arranged with prior notification and approval. Electives are generally two or four weeks in length, depending on the rotation sponsor’s and fellow’s preferences.

Call responsibilities are shared equally amongst all critical care fellows.

On weekdays (Monday through Friday), fellows take 24 hour, in-house call, with one fellow being on call each night.

Fellows are on a night float system that lasts for 2 weeks at a time. The night float fellow comes in at 1800 and leave at 0700 the following morning. Thursday is the day off for the night float fellow. There is a 24-hour call fellow on Thursdays. Weekend days are covered by the same fellow in order to reduce the amount of weekends fellows work. Fellows only work on holidays that they are scheduled and the holidays worked are decided by the fellows at the beginning of each year.

On weekends (Saturday and Sunday), one fellow will cover both days (48 hours) on home call.

Applications are reviewed by a group of faculty. Based on the strength of the candidate and their application materials, an interview is offered.

Fellows generally show up at around 7AM. Morning rounds start at 7:30 and are most often done by 9:30-10AM. Fellow lectures, journal clubs, morbidity and mortality conferences, etc. are from 3-4 pmseveral days per week. . Fellows are expected to be clinically working and supervising residents which includes social work and nurse navigator rounds,checking up on patients, supervising and performing procedures, consulting teams and other services, following up on test results, imaging, interventions. Fellows are expected to run the list with the team to make sure tasks are done for the day and follow up for each plan that was discussed at rounds. Fellows report appropriately to faculty and also sign out to the call fellow and call faculty at 6PM.

Yes, since November 2010 the University uses Epic for medical records, including documentation and orders.

Yes. Fellows are allotted a fund of $2,400 to provide support for specific needs during the course of their training, including attendance at one national meeting (attendance at the Society of Critical Care Medicine’s annual meeting is highly encouraged).

Fellows average less than 60 hrs per week. Duty hours are tracked by MedHub.

The fellowship is based in the Surgical and Neurosciences Intensive Care Unit (SNICU) and the Cardiovascular Intensive Care Unit (CVICU). Fellows actively participate in the care of all patients in these units and are exposed to a broad and comprehensive patient base encompassing all aspects of critical care medicine. Experiences include, but are not limited to, complicated post-operative patients (solid organ transplant, heart and lung transplant, ventricular assist devices and total artificial heart, major vascular, etc.), neurological disease (stroke, intracranial bleed, neoplasm), trauma, respiratory failure/ARDS, cardiac failure and ischemia, liver and kidney dysfunction, and sepsis. The critical care service is responsible for all ventilator management, invasive monitoring, and coordination of care among the participating services. There is a particular emphasis on non-invasive cardiac output monitoring and procedural and diagnostic ultrasound.

Faculty evaluate fellows quarterly using MedHub and the director meets semiannually, and as needed, with each fellow to review these evaluations and develop corrective strategies if indicated. The evaluations are based on the six ACGME core competencies. Nursing and other support staff also evaluate the fellows quarterly. These evaluations are also reviewed with the fellow during their semiannual meeting with the director.

Yes. Residents of all training levels from multiple services rotate through the SNICU. In addition, the SNICU rotation is a popular elective among third and fourth year medical students. Fellows are encouraged to be active in both the clinical/bedside education of these learners as well as participating in didactic lectures to residents and medical students.