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Critical Care Track for Nephrology - Infectious Disease

In an effort to allow collaboration and pursuit of a multidisciplinary program, our 3 critical care track positions provide Nephrology and Infectious Disease fellows with a unique training experience. Fellows will be accepted into the combined track, with some critical care training integrated into their first two years of their respective subspecialty. By the time they are in their PGY-6 year, there will be a heavy focus on pure critical care training encompassing all aspects of intensive care medicine. Please see our proposed curriculum.

Rotation schedule Infectious Disease/Nephrology Critical Care Track

PGY4 rotations

Medical Intensive Care: 1

Includes buddy daylight shifts with PCCM Fellow 

PGY5 rotations

Medical Intensive Care: 1

Includes buddy daylight shifts with PCCM Fellow 

PGY6 rotations

Medical Intensive Care: 4

Cardiovascular/Thoracic ICU: 2

Trauma ICU: 1

Neurosurgical ICU: 1

Anesthesiology: 1

CCU: 1

Nephrology/Infectious Dis Consult: 2

Orientation

Each fellow will participate in:

STAR Center Skills Lab Simulation - This is a one day course covering: Central and arterial lines: Indications, contraindications, preparation, technique, complications and their management. Bronchoscopy: Integrating fundamental bronchoscopic techniques, gaining cognitive knowledge and clinical decision making skills. Airway management: Provide practical, effective skills and strategies for intubation.

Cadaver Lab – The human cadaver lab in collaboration with our Anesthesia Residency Program augments their procedural experience in direct laryngoscopy, bronchoscopy, chest tube placement, pigtails, perc trach and crics ensuring optimal hands-on training while providing confidence and ensuring patient safety. The lab also enhances the fellows understanding of the gross human anatomy.

In addition the Critical Care Track Fellows will be required to attend key lectures, MICU orientation, ventilator training and buddy calls.

ICU rotations

Each fellow is required to have 6 months of Medical ICU training, which encompass all aspects of critical care, including ARDS, PE, shock, respiratory failure, upper and lower GI bleeds, liver failure, hematological/oncological emergencies, toxic and metabolic disorders, and renal disorders. During these months, fellows will learn conventional and unconventional modes of mechanical ventilation including, Bilevel, APRV, and PAV. Critical Care track fellows will begin their MICU training during their PGY 4 year. As the fellow progresses their role will become more of a Junior attending leading MICU team rounds and reviewing action plans with the attending physician. This graduated responsibility provides the fellow more autonomous growth and confidence in handling an ICU upon graduation.

Fellows rotating through our Trauma Unit will obtain ATLS certification, learn primary and secondary surveys, may participate in trauma codes, and help run the Trauma ICU.

Cardiovascular/Thoracic ICU rotation - The fellow will gain experience with flow directed pulmonary artery catheters, post-operative care of cardiothoracic patients, and manage the care of those patients admitted to the intensive care unit following coronary artery bypass graft surgery, valvular heart surgery, and thoracic surgery. The fellow will also gain experience in ECMO, VAD and transplants.

Neurosurgical ICU - 6 of our current faculty members are also boarded in Neurocritical Care. This 2 month rotation provides the fellow with instruction and experience in the diagnosis and management of those diseases in the neurosurgical intensive care setting including: a variety of neurological illnesses (e.g. prolonged mechanical ventilation, increased intracranial pressure, anemia, hypotension, low cardiac index, sepsis, and coagulopathies).

Anesthesiology

This one month rotation provides the fellow with instruction and experience in the placement of endotracheal tubes and airway management in patients preparing for surgery.

Didactics include:

  • Core Curriculum Didactic Lectures
  • Journal Club
  • Critical Care Case Conference
  • Board Review
  • M&M case review and RCA conference
  • Research Quality Improvement Conference

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