Critical Care Anesthesiology Clinical Training

Fellow Duties & Call

We view our fellows as integral parts of the ICU team, and co-leaders with our faculty. Their role is that of a high-level practitioner and not as a resident. As such, our fellows are expected to oversee our mid-level providers (residents & APPs) to ensure plans are carried out, and appropriate care is delivered. They assist with difficult procedures, such as high-risk central line placement, and carry the code/airway pager for our Ashley River Tower when on their CTICU rotation. When in the CTICU and MSICU, our fellows arrive around 6:30 AM and leave around 5:00 PM when our night float ICU attending arrives. They have no weekday in-house or home call duties. Our fellows weekend responsibilities consist of approximately one weekend per month covering our Cardiothoracic Surgical ICU. They will work with our daytime faculty member assisting with rounds and patient management during daytime hours. There is no overnight component.

Overview:

• Work with ICU Attending to lead Rounds & direct patient care
• Lead ICU Team of APPs & Residents
• Coordinate with Surgical Attendings & Fellows
• Run hospital-wide Code & Airway team in the Ashley River Tower
• Our fellows weekend responsibilities consist of approximately one weekend per month covering our Cardiothoracic Surgical ICU. They will work with our daytime faculty member assisting with rounds and patient management during daytime hours. There is no overnight component.

ICU Rotations

A major source of strength in our program is the wide-ranging ICU experience our fellows are offered here at MUSC. Our fellows' "home base" is our Cardiovascular and Medical-Surgical ICUs. Our CTICU is staffed exclusively by our Anesthesia faculty, and our MSICU is staffed by Anesthesia & Pulmonary Critical Care faculty. In addition our fellows have the opportunity to work with Neurointensivists in the NSICU, and Surgical Critical Care physicians in our Shock & Burn ICU. This provides our fellows with a broad experience in all realms of critical care illness & provider backgrounds making them well rounded practitioners of Critical Care Medicine.

An Overview of patient populations our fellows learn from is listed below:

• Cardiovascular ICU
  • Postop Cardiac, Thoracic, & Complex Vascular Surgery Patients
  • Heart & Lung Transplant, Durable LVAD
  • Temporary Mechanical Circulatory Support
  • ECMO, IABP, & Impella
  • Complex Cardiology Patient
  • Post Cardiac arrest, Acute Myocardial Infarction, Decompensated Heart Failure
• Medical-Surgical ICU
  • Mix Medical & Abdominal Surgical Patients
  • ARDS, Septic Shock, Hematologic & Oncologic Emergencies
  • GI Hemorrhage, Pulmonary Hypertension, Perforated Viscous
• Neurosurgical ICU
  • Postop Neurosurgical patients
  • Acute Ischemic & Hemorrhagic Stroke
  • CNS Infections, Status Epilepticus, & Neuromuscular Disorders
• Shock Trauma ICU
  • Trauma, Burn, Liver Transplant
  • Abdominal Catastrophes

Elective Rotations

Our Fellowship also prides itself on our flexible Elective Opportunities. Each fellow has 3 elective months where they can choose from a large selection of opportunities. There is also some ability to build a rotation or tailor it to a fellows specific needs. Listed below are some example elective opportunities available:

• Echocardiography & Point of Care Ultrasound
• Palliative Care
• Pulmonary Consults
• Nephrology Consults
• Infectious Disease
• Nutrition
• Research
• Regional Anesthesia