Anesthesiology Critical Care Fellowship Programs: Comprehensive Training for Future Intensivists

For incoming fellows, our anesthesiology critical care fellowship program is meticulously structured to provide a robust and comprehensive educational experience, regardless of their chosen career path within critical care. From the outset, we prioritize a strong foundation in critical care principles, ensuring each fellow is well-prepared for the challenges of the intensive care environment.

The fellowship year commences in July and August with an intensive boot-camp lecture series. This crucial onboarding period is designed to facilitate a smooth transition into our demanding units. These focused lectures are delivered by our institution’s leading experts, each deeply specialized in high-yield critical care topics. For instance, fellows receive in-depth education on Extracorporeal Membrane Oxygenation (ECMO) directly from our ECMO Medical Director, and gain insights into Ventricular Assist Devices (VADs) from a renowned heart failure cardiologist. Our blood bank director leads sessions on optimal blood management strategies, among other vital topics. Importantly, these foundational lectures are shared with our junior cardiothoracic surgery fellows, fostering early interdisciplinary collaboration and building a cohesive, familiar working environment from day one.

Throughout the academic year, our program features a diverse range of recurring educational activities designed to reinforce learning and foster continuous professional development. Attending-led didactic lectures are a cornerstone of our curriculum. These sessions are presented by our attending physicians, who share their extensive knowledge and practical expertise across a broad spectrum of critical care areas. Topics span from the fundamental understanding and management of sepsis to advanced techniques in cardiac output monitoring and the complexities of pulmonary hypertension.

Our Journal Club sessions offer a critical appraisal of the latest medical literature. Led by a fellow in collaboration with a faculty mentor, these sessions delve into recent, impactful studies and revisit pivotal landmark trials that have shaped modern critical care practice. This rigorous analysis cultivates fellows’ ability to critically evaluate evidence and apply it to clinical decision-making. Similarly, Challenging Case Discussions provide a platform for collaborative learning from real-world clinical scenarios. Fellow-led with attending guidance, these discussions center around recent difficult cases encountered within our division, fostering an environment of shared learning and problem-solving. These sessions are consistently rated as highly educational and directly relevant to the daily clinical challenges faced in critical care.

To ensure fellows are thoroughly prepared for board certification, our Board Review sessions commence early in the academic year. These dedicated sessions are designed to prime fellows for the critical care board exam, reinforcing core concepts and familiarizing them with the exam format and content. Furthermore, our Multidisciplinary Critical Care Conference is a unique and valuable interdepartmental initiative. In collaboration with the divisions of Pulmonary Critical Care, Surgery Critical Care, Neurocritical Care, and Pediatric Critical Care, this monthly conference features lectures delivered by each division in rotation. Topics are carefully selected to be relevant to all intensivists, promoting a shared understanding of diverse management styles and perspectives across different critical care specialties. Finally, POCUS (Point-of-Care Ultrasound) reading sessions are integral to our hands-on training approach. These sessions are designed to continuously refine fellows’ POCUS image acquisition skills and optimize their technique through expert feedback and practical application.

We place a strong emphasis on echocardiography and point-of-care ultrasound (POCUS) education within our anesthesiology critical care fellowship. Our comprehensive POCUS curriculum includes a series of dedicated lectures delivered throughout the year, providing a structured and progressive learning experience. Our faculty, credentialed in POCUS, regularly leads image reading sessions, offering fellows consistent feedback and opportunities for skill refinement. This focused training enables fellows to acquire the necessary knowledge and practical skills to confidently pursue the Examination of Special Competence in Basic Perioperative Echocardiography (CCEeXAM) administered by the National Board of Echocardiography. Furthermore, it equips them to meet the training requirements for certification in Advanced Perioperative Transesophageal Echocardiography. For fellows with a particular interest in echocardiography, we offer an elective rotation in perioperative Transesophageal Echocardiography (TEE), providing ample opportunity to build the experience necessary for Basic PTEeXAM or Advanced PTEeXAM certification in perioperative TEE.

Beyond didactic learning, our program incorporates immersive simulation experiences to enhance fellows’ preparedness for critical situations. Throughout the year, fellows participate in several large-scale multidisciplinary simulations alongside cardiothoracic surgeons, CTICU nurses, physician assistants, and nurse practitioners. These high-fidelity simulations are meticulously designed to replicate life-threatening emergencies commonly encountered in the CTICU. The focus extends beyond medical decision-making to emphasize the critical importance of team-work dynamics and effective communication in achieving optimal patient outcomes in crisis scenarios.

Recognizing the holistic development of our fellows, we offer a series of “all-fellow” didactic sessions and seminars organized by the Department of Anesthesiology. These sessions are open to fellows from all anesthesiology subspecialties, fostering a broader departmental learning community. Topics covered are diverse and essential for professional growth, including physician wellness strategies, financial literacy for early career physicians, cultural competency in healthcare, addressing healthcare disparities, quality improvement methodologies, clinical research design principles, and effective communication skills. To further support professional development and board exam readiness, practice OSCEs (Objective Structured Clinical Examinations) and mock oral board exams are held annually, providing valuable preparation for all anesthesiology fellows eligible for these examinations.

Our program’s vibrant academic environment is designed to foster scholarly activity and engagement in quality improvement initiatives. All fellows are expected to actively participate in a quality improvement project throughout their training year. This hands-on experience involves fellows in all stages of a project, from the initial planning and implementation phases to the evaluation of improvements and enhancements to current patient care practices. Furthermore, scholarly work is a core component of the fellowship. Our fellows have a strong track record of contributing to the medical literature and presenting their work at professional meetings. Past fellows have authored book chapters, presented compelling case reports at departmental grand rounds and multidisciplinary institutional conferences, and showcased their research at national anesthesiology and critical care conferences. Opportunities to participate in clinical outcomes research and clinical trials are readily available, with fellows consistently achieving abstract publications in peer-reviewed journals.

To provide personalized guidance and support, each fellow is paired with a faculty mentor early in the fellowship year. These mentors serve as invaluable resources, offering advice, guidance, and a sounding board for navigating the challenges of fellowship and early career development. Recognizing the importance of professional coaching, our department also provides access to professional coaching resources. Interested and motivated fellows are encouraged to take advantage of these resources to further propel their career trajectory and leadership potential.

Critical care fellows in our program receive comprehensive academic support throughout their training. At the fellowship’s commencement, each fellow receives two essential critical care textbooks published by the Society of Critical Care Medicine: Comprehensive Critical Care: Adult, a definitive review text, and Self-Assessment Adult Multiprofessional Critical Care, a valuable resource for board exam preparation with practice questions and answers. Fellows also receive an academic stipend to support academically and professionally related expenses, such as educational resources or professional development activities. We strongly encourage fellows to present their scholarly work at national conferences and provide generous financial support to cover travel and conference-related expenses. To facilitate both academic and clinical work, our fellows benefit from dedicated office space designed for focused work and relaxation. Finally, generous meal cards and department-provided weekday dinners are provided to further support our fellows’ well-being and work-life balance during their intensive training year.

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