Critical Care Medicine Curriculum
General Goals & Objectives
Fellows become familiar with the principles of Critical Care Medicine and their application in the management of a full range of clinical problems in a wide gamut of patients.
A. Fellows are to become clinically expert in all aspects of:
B. Fellows provide cogent discussions and lectures in critical care, monitoring and basics of transplantation and echocardiography.
C. Fellows are required to become proficient at providing and coordinating multispecialty and multidisciplinary critical care delivery through exemplary communication and effective interaction with various disciplines.
D. Fellows become proficient at management of intensive care unit functions including, but not limited to, coordinating patient admissions and discharges from ICUs in a multispecialty environment and development and implementation of guidelines for patient care.
E. Fellows in this program are strongly encouraged to develop individual clinical research projects or to participate in any of the ongoing clinical research projects of the Critical Care Section. During the course of the fellowship, Fellows will become familiar with the basic components of and issues pertaining to clinical research.
F. Fellows are required to become certified in all of the following life support courses before the end of their training (The Department of Anesthesiology wil arrange and pay for all courses):
Specific Clinical Rotations
Neurosciences/Spine ICU
Fellows will become familiar with the diagnosis and management of patients with subarachnoid hemorrhage, spinal cord injury, cerebral artery vasospasm, increased intracranial pressure, hydrocephalus and other neurologic problems common to the neurosurgical patient population.
Cardiothoracic ICU
Fellows will become proficient in perioperative management of cardiac, vascular, thoracic, and end-stage heart failure patients. They will also become thoroughly familiar with mechanical circulation assist devices (LVADs, balloon pumps), guidelines of immuno-suppression regimens, renal replacement therapies, complex hemodynamic management and echocardiography. To read highlights of the Cardiac Surgery program, click here.
Surgical ICU
Fellows will become proficient in the pre-operative and post-operative care of patients undergoing solid organ transplantation, trauma patients (excluding burns), patients with various oncologic diagnoses and treatments and surgical patients with significant co-morbid conditions.
Coronary Care Unit
Fellows will become well versed in the current diagnostic and therapeutic techniques involving care of patients with acute myocardial ischemia and infarction. This will include anti-ischemic therapy, appropriate interventional therapeutic techniques, and arrhythmia recognition and treatment.
Medical ICU
Fellows will gain experience in the evaluation and care of the general medical patient population common to critical care units. This will include the care of patients with acute and chronic lung disease, heart failure, renal insufficiency/failure, and infectious diseases common to this patient population.
Pediatric ICU
In the Pediatric Intensive Care Unit of Children's Memorial Hospital, fellows will gain experience in the evaluation and medical management of critical care ill pediatric patients along with pharmacologic and organ support in settings of sequential organ failure.
Echocardiography
Fellows will learn the basics of both transthoracic and transesophageal echocardiography techniques. Fellows will gain experience in the performance of these procedures and learn their diagnostic capabilities and limitations.
Educational Responsibilities
The fellow will participate in the educational processes for residents assigned to the critical care rotation. Fellows will prepare and present lectures, in conjunction with faculty, to residents assigned to the intensive care units. Topics to be discussed include:
• Hemodynamic monitoring
• Hemodynamic support
• Airway management outside the operating room
• Trauma management
• Mechanical ventilatory support
• Essentials of Respiratory care
• Neurologic critical care
• Metabolic imbalance
• Nutritional support
• Sedation/analgesia in the intensive care unit
Proposed Examination Process
Critical Care fellows will take a nationally provided, written, in-training examination sponsored by the Society of Critical Care Medicine. This examination will serve as both an evaluation tool and as preparation for future board certification testing.
Fellow Evaluations and Feedback
Fellows are given daily feedback on their performance on rounds and during routine patient care. Evaluations are performed on a monthly basis, and any difficulties are addressed at the time with appropriate feedback. Fellows meet with the program director on a quarterly basis to review the assessments of all faculty members as reported to the departmental clinical competence committee.
