Critical Care Medicine Fellowship

Trauma, burn, transplant, and surgical intensive care unit (SICU) 

A closed ICU that comprises 36 beds allocated to an array of critically ill or injured surgical patients requiring pre-operative stabilization, post-operative intensive care after elective or emergency surgery, or critical care following complications of surgical illnesses. Patients admitted to the SICU arrive from all the surgical subspecialties, thus providing a broad base of experiences to trainees.

Cardiothoracic intensive care unit (CTICU)

A closed 36-bed unit devoted to the perioperative care of a diverse mix of routine and complex cardiac and thoracic surgical patients. Among other strengths, we have world-class lung transplantation, cardiac transplantation, mechanical cardiac support devices (LVAD, ECMO), complicated valvular repair/ replacement, and aortic repair programs.

Additional ICU’s 

Fellows also spend mandatory time rotating in our academic medical ICU, dedicated surgical oncology ICU, and one of our large high acuity community mixed ICUs.  Additional electives in the coronary care unit and neurology/neurosciences ICU are available.  This broad clinical exposure ensures trainees will see the spectrum of critical care medicine pathology during their fellowship. Other intensive care units that play a significant role in our fellowship training include a dedicated oncology/BMT ICU, progressive care ventilator rehabilitation unit, and an emergency department trauma and critical care unit.

Our goal is to train fellows that are future leaders in the specialty of critical care medicine, and a multi-faceted didactic program underlies that goal. Our weekly multidisciplinary critical care lecture series (MDCCLS) provides the foundation for a strong base of knowledge. Attending faculty speakers from various disciplines participate, delivering a distillation of the most current thinking in all facets of critical care medicine. We also have a weekly Fellows Critical Care Lecture Series (FCCLS) with speakers from our own Division of Critical Care (view some of our previous recorded lectures). As part of the FCCLS, each fellow gives two lectures per year on the topics of their choice.

In order to ensure successful board certification post-graduation, we provide a robust CCM written board review lecture series. This also includes an in-service practice training exam during your fellowship year. Our goal is to provide trainees with all of the tools needed to become board-certified intensivists. 

We have also developed a formal CCM ultrasound course aimed at preparing fellows for board certification in Advanced Critical Care Echocardiography now offered by the National Board of Echocardiography.  Our CCM point of care ultrasound curriculum includes hands-on scanning, didactics, and case-based lecture review.  We also have opportunities with transesophageal echocardiography (TEE) through a dedicated rotation, case-based lectures series, and simulation with our state-of-the-art TEE simulator.

At our monthly journal club and research-focused lectures, both faculty members and fellows participate in lively discussions inspired by the most current literature.

Our monthly clinical outcomes and unit-based quality Improvement meetings flush out the administrative component of training. These settings provide a forum to discuss patient safety and opportunities to improve our delivery of critical care medicine.  Each fellow will be responsible for the completion of a quality improvement project which will often lead to publication opportunities.

Innovations in the education of our fellows are constantly being explored and expanded. Currently, we are collaborating with the nationally recognized Clinical Simulation Center at the WashU Medicine to develop novel approaches to fellowship, resident, and medical student education. We host hands-on procedural labs to round out exposure to all aspects of critical care (ventilator rounds, surgical airway lab, REBOA lab, etc). Additionally, we have a web-based critical care library (journal resources and taped lectures) that provide our fellows with a consistently up-to-date, accessible learning resource.

The Department of Anesthesiology is heavily funded by grants and consistently ranks among the top five nationally in NIH funding.

Clinical and basic science investigations occur in all the subspecialty areas, and many include partnerships with experts in other disciplines such as cardiology, hematology, or endocrinology. Fellows are offered mentorship in developing their own research projects, as well as encouraged to participate in ongoing research projects. All research seminars and research conferences are open to our fellows, and our monthly clinical research group is a valuable source of project development ideas.

We value national involvement, and all ACCM fellows receive membership in the Society of Critical Care Medicine (SCCM) and the Society of Critical Care Anesthesiologists (SOCCA).  Fellows also have access to discretionary funds to facilitate attendance at national meetings.

This fellowship program participates in the San Francisco Match’s Central Application Service and is approved by the Accreditation Council for Graduate Medical Education (ACGME).

Critical care medicine trainees must be board-eligible in anesthesiology, surgery, obstetrics, or emergency medicine.