Required Rotations

Our curriculum is organized into 13, 4-week rotations (blocks). All fellows complete three to four blocks in the Surgical ICU, three blocks in the Cardiovascular ICU, one block in the Neurosurgical ICU, one block in the Critical Care Medicine Unit, one block in the Emergency Critical Care Center, and one block of Critical Care Ultrasonography and Advanced Critical Care Echocardiography. The fellow is able to choose from a variety of elective rotations to fill the remaining time. These required rotations are summarized below.

Elective Rotations

A resident's remaining blocks are used to gain additional clinical experiences, to conduct research or engage in other scholarly activity relevant to critical care. Fellows are given freedom to tailor this experience based on their interests. Common choices include research, critical care nutrition, inpatient nephrology consults, inpatient infectious disease consults, ECMO, VA-SICU and radiology.

Procedural Skills

While there is no requirement for fellows to complete a specific number of procedures, all of our graduates are expected to be competent at performing procedures that are essential for the practice of critical care medicine.  This is accomplished through simulation and rotations, as described above. In addition to the technical skills, fellows must also learn to appropriately weigh the risks and benefits of procedures in patients with a complex array of medical and surgical conditions.

Throughout their clinical rotations, trainees gain experience with:

  • transthoracic echocardiography
  • transesophageal echocardiography and ultrasonography for vascular access
  • pleural and lung ultrasonography
  • airway management
  • invasive and noninvasive mechanical ventilation
  • percutaneous tracheostomies
  • bronchoscopy
  • thoracentesis and tube thoracostomy
  • transcutaneous and temporary transvenous pacemakers
  • pharmacologic and mechanical support of cardiogenic shock
  • use of cardiopulmonary resuscitation
  • cannulation for veno-venous and veno-arterial ECMO
  • use of technology such as rapid infuser devices for the management of massive blood loss
  • placement of arterial, central venous and pulmonary artery catheters
  • placement and management of lumbar drains
  • prescribing enteral and parenteral nutrition
  • use of multimodal approaches for analgesia and anxiolysis