For medical professionals seeking intensive and focused training in critical care, Yale New Haven Hospital offers unparalleled opportunities through its integrated fellowship programs. While structured as a component of a comprehensive three-year Pulmonary Critical Care fellowship, the critical care element provides a robust and immersive experience that can be considered as impactful as many dedicated 1-year critical care programs paid. Fellows gain exposure to a diverse range of intensive care units (ICUs) across multiple campuses, ensuring a well-rounded and advanced education in managing critically ill patients.
The Critical Care Fellowship at Yale is distinguished by its rotation schedule across Yale-New Haven Hospital’s York Street and Chapel Street campuses in New Haven, and Bridgeport Hospital, home to Connecticut’s only specialized burn ICU. This multi-site approach broadens the scope of training, exposing fellows to varied patient populations and clinical environments. Furthermore, elective time is incorporated to align with individual career aspirations and prior medical experience, making the program highly customizable.
York Street Campus Medical ICU: A Premier Training Ground
The York Street Campus Medical ICU (MICU) stands as a flagship unit within the Yale New Haven Health System, directed by Dr. Shyoko Honiden. Recognized as a leading ICU in the region, this state-of-the-art facility located within the Smilow Cancer Hospital features 40 ICU beds and 15 step-down beds. The MICU team manages a high daily census, averaging 36 critically ill patients with complex and life-threatening conditions, including septic shock, acute respiratory distress syndrome (ARDS), and acute liver failure. Annually, the unit admits over 5000 patients, with approximately 30% requiring mechanical ventilation, highlighting the acuity and intensity of cases managed here. The York Street MICU also serves as a tertiary referral center, receiving 500 transfers each year for specialized care unavailable at referring hospitals.
Training within the York Street MICU is structured around four teams, each led by experienced Pulmonary and Critical Care Medicine (PCCSM) faculty. Critical Care fellows work collaboratively with residents and advanced practice providers, fostering a team-based approach to patient care. This ICU is a major educational hub, training medical students, Internal Medicine residents, and fellows from various departments, including Surgery and Emergency Medicine. The MICU is also a vibrant center for clinical research, with faculty-led studies in areas such as acute lung injury, sepsis, and cognitive impairment, offering fellows opportunities to engage in cutting-edge medical advancements. Crucially, the York Street MICU is staffed by in-house intensivists around the clock, ensuring continuous supervision, high-quality patient care, and ongoing education. Critical Care Fellows participate in both daytime (approximately 12 weeks) and night rotations (around 8 weeks, in 2-week blocks, Monday-Thursday). Day rotations emphasize leadership, with fellows leading work rounds, teaching junior staff, and performing procedures under attending supervision. Night rotations focus on supervising residents, managing admissions, and procedural skills under the guidance of a nocturnal intensivist. Progressive responsibility is a hallmark of the program, with fellows gradually taking on roles in ICU triage.
Chapel Street Campus Medical ICU (St. Raphael’s): Diverse Clinical Exposure
The Chapel Street Campus MICU, located within the 500-bed St. Raphael’s campus, provides a different but equally valuable clinical experience. This 16-bed MICU, under the direction of Dr. Aydin Pinar, often sees patient census rise to around 20 during peak winter months, expanding into an adjacent step-down unit. Two teams, each led by a Pulmonary and Critical Care attending, guide fellows and primary care residents, ensuring personalized mentorship and training. Similar to the York Street campus, 24/7 supervision, quality care, and education are maintained through on-site intensivists and tele-ICU support. While residents are present overnight, Critical Care fellows on this campus do not have in-house overnight responsibilities, offering a different perspective on ICU management within a large hospital system.
Coronary Care Unit (CCU): Specializing in Cardiovascular Critical Care
The 14-bed Coronary Care Unit (CCU) offers specialized training in the critical care management of cardiac patients. This unit focuses on patients with acute myocardial infarction, post-cardiac catheterization needs, congestive heart failure, left ventricular assist devices (LVADs), and heart transplants. Staffed by attending cardiologists, cardiology fellows, and medical residents, the CCU rotation allows Critical Care fellows to immerse themselves in advanced heart failure management, mechanical circulatory support devices, echocardiography, and right heart catheterizations. This rotation is crucial for fellows aiming to develop expertise in the cardiovascular aspects of critical care medicine.
Surgical ICU (SICU): Mastering Post-Operative and Trauma Critical Care
The 21-bed Surgical ICU (SICU) rotation is designed to cultivate competence in managing critically ill patients within the unique surgical intensive care environment. Yale New Haven Hospital’s multidisciplinary SICU admits patients from a broad spectrum of surgical services, including obstetrics and gynecology, general surgery, oncology, trauma, orthopedics, ENT, thoracic surgery, and transplant surgery (liver and renal). As a designated trauma center, the SICU also manages a wide array of trauma cases. Critical Care fellows in the SICU function as surgical intensive care fellows, providing direct patient care under the guidance of critical care trained faculty from trauma/general surgery, anesthesiology, and emergency medicine. This month-long rotation offers invaluable experience in trauma management and pre- and post-operative critical care. There are no overnight calls during the SICU rotation, promoting a focused learning environment during daytime hours.
Cardiothoracic ICU (CT ICU): Expertise in Cardiac and Thoracic Surgical Critical Care
The 18-bed Cardiothoracic ICU (CT ICU) provides highly specialized training in the critical care of patients undergoing cardiac and thoracic surgery. This multidisciplinary unit manages a high volume of general cardiac and thoracic surgery cases, along with a robust cardiac transplantation program and an expanding extracorporeal life support (ECLS) and mechanical circulatory support program. Fellows participate in multidisciplinary work rounds with surgery residents, advanced practice providers, pharmacists, and dieticians, learning to manage complex patient physiology alongside faculty dual-trained in Anesthesiology and Critical Care, or Cardiothoracic Surgery and Critical Care. The CT ICU rotation offers deep insight into the perioperative management of cardiothoracic patients and advanced circulatory support techniques. Similar to the SICU, there are no overnight calls in the CT ICU rotation, allowing for concentrated daytime learning.
Neurocritical Care Service (NICU): Specialized Neurological Critical Care Management
The 14-bed Neurocritical Care Service (NICU), with overflow capacity into the SICU, offers specialized training in neurological and neurosurgical critical care. This 4-week rotation focuses on developing skills to evaluate and manage critically ill patients with a wide range of neurological conditions, including subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, traumatic brain injury, status epilepticus, Guillain-Barre Syndrome, brain tumors, spinal cord diseases, and CNS infections. Fellows are expected to attend neurology and neurosurgical conferences and have the opportunity to observe neurosurgical procedures in the operating room. NICU work rounds are led by highly skilled neurointensivists, including medical director Dr. Emily Gilmore and faculty members Dr. Guido Falcone, Dr. Kevin Sheth, and others. This rotation is essential for fellows seeking comprehensive critical care training that includes neurological emergencies and intensive care management. There are no overnight calls during the NICU rotation.
Interventional Pulmonary Rotation (IP): Advanced Airway and Pleural Procedures
The Interventional Pulmonary (IP) service offers unique training in advanced diagnostic and therapeutic bronchoscopic and pleural procedures. Yale-New Haven Hospital’s IP program, directed by Dr. Kyle Bramley, is a regional leader in advanced pulmonary interventions. During a month-long rotation on the IP service, Critical Care fellows develop foundational bronchoscopy skills and learn chest tube management. They gain exposure to advanced bronchoscopic procedures, pleural procedures, and percutaneous tracheostomies, guided by Dr. Erin Debiasi, the Procedural Education Director for the IP service. This rotation provides specialized procedural skills that are highly valuable in critical care practice.
Bridgeport Hospital Burn ICU: Specialized Burn and Trauma Critical Care
Rotation to Bridgeport Hospital provides a unique experience in the state’s only burn center. Fellows rotating through the Burn ICU gain specialized knowledge in the critical care of patients with severe burns, including fluid management, inhalational injuries, and nutritional support in these complex and vulnerable patients. This rotation complements the trauma experience gained in the SICU at York Street, broadening the fellow’s expertise in managing diverse forms of critical illness and injury.
Yale New Haven Hospital’s critical care fellowship, while part of a three-year program, offers a concentrated and comprehensive training experience across diverse ICUs. For those seeking intensive, advanced critical care education, the program provides a robust foundation and skill set comparable to dedicated 1 Year Critical Care Programs Paid, setting fellows on a path to becoming leaders in the field of critical care medicine.
