As a multi-disciplinary unit, the fellow develops clinical experience in the management of patients with medical and surgical emergencies, along with trauma, neurosurgical and cardiothoracic emergencies.
The ICU team consist of one critical attending, one fellow, multiple senior and junior residents and medical students. The residents and interns are from different specialties including surgery, internal medicine, anesthesia, ob-gyn, and emergency medicine. The multi-disciplinary rounds also include nursing staff, pharmacy, nutrition services, physical therapy and case management.
The housestaff present the history and physical findings to the fellow and the attending for each patient on morning rounds and then an evidence-based discussion of the case ensues, focusing on the physical and hemodynamic findings, differential diagnoses and management plan. In addition to clinical bedside review, the team reviews the radiologic images for each patient. Cases provide a stimulus for discussion on topics including hemodynamic devices, ventilator modes and management, and review of evidenced based data.
- Teaching rounds
- Residents supervision and teaching
- Performing or supervising bedside procedures
- ICU consultation services
- Leading the emergency response team in the hospital
- Triaging of critically ill patients
- Communicating management plans with specialists involved
- Conducting family and patient discussions / palliative care
Departmental Conferences and Lectures
- Core Lecture Series: Weekly one hour lecture given by a critical care attending on a topic from the curriculum. Fellows, residents, and medical students attend.
- Fellow Core Lecture Series: Twice weekly, a fellow gives a lecture to housestaff and attendings covering a basic topic from the critical care curriculum. The fellows play an active role in planning of these conferences.
- Fellow lectures: Advanced monthly meeting / conference between the faculty and the fellows discussing high-yield topics and advanced critical care evidence-based interventions.
- Morbidity and Mortality Conference: Each fellow will present a case at the monthly conference. The fellow will complete a self-analysis form for each case, in attempts to improve patient safety, patient care, and education. The fellow will perform a targeted literature review and present the data with respect to each case. The Morbidity and Mortality Conference will serve as stimulus for a quality improvement project.
- Journal Club: Occurs monthly. Two articles from topics in current journals are presented by the fellow and discussed. Specifically, whether practice patterns should change based on the data review. A review of all abstracts from Critical Care Medicine is also reviewed.
- Research meetings: Conducted monthly with the aim of guiding interested fellows the process of conducting a quality improvement or a research project.
- Department Grand Rounds: Anesthesia, Surgery, and Medicine departments each have weekly grand rounds. Fellows and faculty attend to one of the GRs when critical care topics are discussed.