Anesthesiology & Pain Medicine >> Education >> Fellowship in Critical Care Medicine

Fellowship Training Program:
Fellowship in Critical Care Medicine

Description

The Critical Care Fellowship Training Program of the University of Washington is a joint one-year program administered by the Departments of Medicine and Anesthesiology. The Program accepts trainees from graduates of residency programs in multiple disciplines, including medicine, anesthesiology, surgery, neurology, obstetrics and gynecology and emergency medicine. Candidates are selected on their preparedness and ability to benefit from the Program.

Completion of this one-year Critical Care Fellowship allows graduates of residencies in Anesthesiology or Obstetrics to sit for the ABA certification exam and graduates of surgical residencies to sit for the ACS certification exam in critical care medicine.  Graduates of internal medicine residencies who have also completed a sub-specialty fellowship are eligible to sit for the ABIM certification exam in critical care after this one-year program, but two years of critical care training are required for Board-eligibility after graduation from an internal medicine residency alone.

The Department of Anesthesiology also offers an innovative 5-year combined Anesthesiology and Critical Care Medicine training program that confers ABA board eligibility if successfully completed. The first three years of training parallel those of trainees in the “conventional” Anesthesiology residency track, and include a total of 5 months of intensive care unit rotations. The last two years of training integrate 12 months of Advanced Critical Care Medicine at the fellow level with conventional anesthesia rotations and electives. The Advanced Critical Care Rotations are jointly administered with the Department of Medicine, and are generally identical to those offered through the conventional one-year Critical Care Medicine Fellowship. For more information about the combined program, please contact Louena Goodwin (206-543-2773; fax 206-543-2958; anesuwa@u.washington.edu).

Considered in the selection process are aptitude, academic credentials, personal characteristics and communication skills.

Training Program

Introduction

Fellows rotate through a broad mix of ICUs within the UW system in a schedule that it is integrated with the Pulmonary Critical Care fellowship. The Critical Care Division of the Anesthesiology Department includes 12 faculty who are trained in Critical Care Medicine, and who contribute to the education of critical care fellows.

The Rotations

Fellows split their time between three clinical sites within Seattle: University of Washington Medical Center; Harborview Medical Center; and Veterans Affairs Puget Sound Health Care System - Seattle Division, with the majority of time spent at Harborview Medical Center and the University of Washington Medical Center (UWMC).

The University of Washington Medical Center offers fellows several ICU services:

  • The Medical ICU Service cares for a variety of patients, including post-operative liver transplant and long-term lung transplant patients, as well as more "routine" medically ill patients. The fellow guides a team of housestaff composed of interns and Internal Medicine R2s oversight by faculty from Pulmonary and Critical Care. The fellow takes the calls for outside transfers from throughout the Pacific Northwest, and is responsible for triaging transfers.
  • The Surgical ICU Service cares for post-operative surgical patients from General Surgery, Neurosurgery, ENT, Urology, Plastics, Orthopedics, and some Obstetrics patient’s requiring ICU stays. The fellow oversees a group of housestaff from Anesthesiology, Surgery and Emergency Medicine. Critical care faculty on this service are from General Surgery, Anesthesiology and Pulmonary Critical Care. Call for fellows on these services is from home.
  • The Cardiothoracic ICU Service serves all Cardiac and Thoracic Surgical patients at UWMC. The fellow is integral in management of the complex pathophysiology associated with these cases. The fellow leads a multidisciplinary team of Surgery housestaff, Acute Care Nurse Practitioners, Physician's Assistants, Pharmacists, and Dietitians. In the "5 Southeast ICU", the patient population consists of a robust general cardiac and thoracic experience, one of the world's most active lung transplantation programs, a large cardiac transplantation program, and a rapidly growing ventricular assist device program. The Critical Care faculty on this service are dual-trained in Cardiac Anesthesiology and Critical Care, or in Cardiothoracic Surgery and Critical Care.
  • Additionally, at UWMC fellows rotate on the Seattle Cancer Care Alliance Service. Fellows work one on one with a Pulmonary Critical Care attending in a co-management role with the hematology/oncology teams. Patients on this service are a mix of bone marrow transplant and solid organ malignancy patients requiring ICU care. This service provides a great opportunity to work with a unique patient population, and provides an opportunity to become facile with bronchoscopy as a tool for the evaluation of immunocompromised patients. Finally, fellows spend a month on the heart failure Cardiology Service. This service cares for severe heart failure patients, pre- and post- cardiac transplant patients, and patients preparing for ventricular assist devices. Coverage is arranged so fellows have ample time to perform right heart catheterization in the cath lab and perform and interpret transthoracic echocardiograms.

Harborview Medical Center is the hospital for King County, and it is also the only level one trauma center in a 5 state region (Washington, Wyoming, Alaska, Montana, and Idaho, or "WWAMI"). The hospital is owned by the county, but managed by the University of Washington. Fellows rotate on three services at Harborview:

  • The Neurocritical Care Service is directed by the Department of Anesthesiology, and provides care for neurosurgical trauma patients with isolated spine and head injuries, and for patients with a variety of neurovascular problems such as subarachnoid hemorrhage. Fellows work with housestaff from Anesthesiology, Emergency Medicine, and Neurosurgery, and faculty from Anesthesiology and Pulmonary Critical Care.
  • Fellows also rotate on the Trauma/Surgical ICU Service. This service manages a large volume of trauma patients from throughout the region, in addition to general, vascular, and thoracic surgical patients in a "closed" ICU model. Residents on the service come from Anesthesiology and Surgery, and critical care faculty are from Anesthesiology, Pulmonary Critical Care, and Trauma Surgery.
  • Finally, the busy Harborview MICU Service cares for critically patients with medical problems from the surrounding area and WWAMI region. Residents on this service are from Internal Medicine, and faculty are from Pulmonary Critical Care. Like the UWMC, call for fellows on Harborview ICU services is from home.

The third site is the Veterans Affairs Puget Sound Health Care System - Seattle Division, where fellows rotate through the following service:

  • The Surgical ICU Service cares for a variety of postoperative patients including post-cardiac surgery patients. This service is directed by the Anesthesiology Department. Residents on this service are from Anesthesiology and Surgery, whereas faculty are predominantly from Anesthesiology and Surgery.

In addition to 9 months of core ICU rotations, electives in radiology, cardiology/echocardiograpy, nephrology, infectious disease, and independent study are available.

Education

A variety of structured educational opportunities exist in addition to ongoing clinical education. The Anesthesiology Critical Care Division holds a quarterly journal club meeting for faculty, fellows, and combined program trainees. Fellows also take part in the Pulmonary Division's weekly Chest Conference, a CPC-type format where fellows present teaching cases for attendings to discuss. This conference is followed by a didactic session each week. Each rotation also has specific didactics, and a weekly multidisciplinary critical care journal club takes place at Harborview. An extensive array of research-based journal clubs and conferences are available through the fellowship.

Research Opportunities

The University of Washington provides a vibrant environment for interdisciplinary biomedical research. The Anesthesiology, Medicine, and Surgery Departments all offer opportunities for research in basic science and clinical aspects of Critical Care and related fields. Collaboration between departments is common, and provides for a rich intellectual atmosphere. The University of Washington School of Medicine ranked sixth among U.S. medical schools in receiving NIH funding in 2005, with grants totaling more than $300 million.

Harborview Medical Center and the University of Washington have an illustrious history of leadership in research in critical care medicine. The Critical Care Division of the Department of Anesthesiology and Pain Medicine is actively involved in outcomes-based research at Harborview Medical Center, providing opportunities for critical care fellows to gain exposure to clinical research. For trainees interested in more in-depth research training with the intent to pursue an academic career, several opportunities exist. The Department offers a two-year research fellowship in basic science or clinical research for trainees interested in focused research training that is funded by an NIH training grant. Another mechanism for research training is present in the form of research "faculty-fellowships" that combine clinical work with basic science or clinical research training, and are which are in turn funded by clinical revenue.

Anesthesiology Faculty

  • Deem, Steven, MD Professor, HMC
    Regular Faculty
    photo of faculty member

    Steven Deem, MD

    Professor, Anesthesiology & Pain Medicine;
    Program Director, Fellowship in Critical Care Medicine;
    Adjunct Professor, Medicine
    (Pulmonary & Critical Care);
    Medical Co-Director, Neurocritical Care Service,
    Harborview Medical Center

    sdeem@uw.edu

    Primary Location: Harborview Medical Center

    Clinical Interests: Improvements in patient care through continued and critical analysis of practices and new developments. He is particularly interested in sedation in the intensive care unit.

    Research Interests: Critical care outcomes and pulmonary vascular physiology.

    Personal Interests: His wife and children, climbing, hiking, skiing and many other outdoor activities which they share as a family.

    UW Medicine Bio | Community of Science Bio

  • Bhagwanjee, Satish, MB ChB Professor & Vice-Chair (Academic Affairs), UWMC
    Regular Faculty
    photo of faculty member

    Satish Bhagwanjee, MB ChB

    Professor & Vice-Chair (Academic Affairs),
    Anesthesiology & Pain Medicine

    satsb@uw.edu

    Primary Location: UW Medical Center

    Clinical Interest: Critical care medicine.

    Research Interests: Sepsis, outcome prediction and risk reduction, global health.

    Personal Interests: Tennis, squash, dancing, reading.

    UW Medicine Bio

  • Fagley, R. Eliot, MD Assistant Professor, UWMC
    Regular Faculty
    photo of faculty member

    R. Eliot Fagley, MD

    Assistant Professor,
    Anesthesiology & Pain Medicine;
    Associate Program Director,
    Fellowship in Critical Care Medicine

    refagley@uw.edu

    Primary Location: UW Medical Center

    Clinical Interests: Anesthesiology, regional anesthesia for thoracic surgery, cardiothoracic anesthesia, transesophageal echocardiography (TEE), critical care, 3D Echocardiography, cardiothoracic critical care, thoracic anesthesia, thoracic surgery, cardiac surgery.

    Research Interests: Blood transfusion, sepsis, TEE, 3D TEE, anesthetic effects on myocardial function, apoptosis, prevention of postoperative renal failure, education of medical students, residents, and fellows.

    Personal Interests: Hobbies include snow skiing, snorkeling, baseball, softball, golf, billiards, live music, and wine.

    UW Medicine Bio

  • Hallman, Matthew R., MD Acting Assistant Professor, HMC
    Regular Faculty
    photo of faculty member

    Matthew R. Hallman, MD

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    mhallman@uw.edu

    Primary Location: Harborview Medical Center

    UW Medicine Bio

  • Joffe, Aaron, DO Assistant Professor, HMC
    Regular Faculty
    photo of faculty member

    Aaron Joffe, DO

    Assistant Professor, Anesthesiology & Pain Medicine

    joffea@uw.edu

    Primary Location: Harborview Medical Center

    UW Medicine Bio

  • Krishnamoorthy, Vijay, MD Acting Assistant Professor, HMC
    Regular Faculty
    photo of faculty member

    Vijay Krishnamoorthy, MD

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    vkrish@uw.edu

    Primary Location: Harborview Medical Center

    UW Medicine Bio

  • Lang, John D., MD Assoc Professor & Co-Assoc. Chief (UWMC Clinical Svs), UWMC
    Regular Faculty
    photo of faculty member

    John D. Lang, MD

    Associate Professor, Anesthesiology & Pain Medicine;
    Co-Associate Chief, UW Medical Center
    Anesthesiology Clinical Services;
    Adjunct Associate Professor,
    Pulmonary & Critical Care Medicine;
    Researcher, Mitochondria & Metabolism Center

    jdlang@uw.edu

    Primary Location: UW Medical Center

    Reseach Interests: Influences of hypercapnia on inflammatory cell signaling pathways in relevant clinical translational models of lung injury. Effects of nitric oxide and nitrite anion on attenuating hepatic ischemia-reperfusion injury during transplantation.

    UW Medicine Bio | Lang Lab Website

  • Lee, Alex, MD Acting Assistant Professor, VAPSHCS
    Regular Faculty
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    Alex Lee, MD

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    leeat@uw.edu

    Primary Location: VA Puget Sound HCS

  • Mackensen, Burkhard, MD PhD Professor & Chief (CT Anesth), UWMC
    Regular Faculty
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    Burkhard Mackensen, MD, PhD

    Professor & Chief (CT Anesth),
    Anesthesiology & Pain Medicine

    gbmac@uw.edu

    Primary Location: UW Medical Center

  • Pauldine, Ronald, MD Clinical Professor & Chief (Critical Care Medicine), VAPSHCS
    Regular Faculty
    photo of faculty member

    Ronald Pauldine, MD

    Clinical Professor & Chief of Critical Care Medicine, Anesthesiology & Pain Medicine; Chief, ICU Medicine Division & Co-Director, SICU, VA Puget Sound HCS

    ronald.pauldine@va.gov

    Primary Location: VA Puget Sound HCS

    UW Medicine Bio

  • Souter, Michael J., MB ChB, FRCA Professor & Chief (HMC Clinical Svs), HMC
    Regular Faculty
    photo of faculty member

    Michael J. Souter, MB BS, FRCA

    Professor, Anesthesiology & Pain Medicine;
    Chief, HMC Anesthesiology Clinical Services;
    Adjunct Professor, Neurosurgery;
    Head, Neuroanesthesia Division,
    Medical Co-Director, NeuroCritical Care Service,
    Harborview Medical Center

    msouter@uw.edu

    Primary Location: Harborview Medical Center

    Research Interests: Neuroanesthesia with neurophysiology and monitoring, critical care of subarachnoid hemorrhage and traumatic brain injury, information technology in anesthesia & medicine, monitoring technology in anesthesia & critical care medicine.

    Personal Interests: Scuba diving (divemaster, mixed gases, closed circuit rebreathers), aviation (Private Pilots License).

    UW Medicine Bio | Community of Science Bio

  • Treggiari, Miriam M., MD, PhD, MPH Professor, HMC
    Regular Faculty
    photo of faculty member

    Miriam M. Treggiari, MD, PhD, MPH

    Professor & Faculty Fellowship Academic Project Coordinator, Anesthesiology & Pain Medicine
    Adjunct Associate Professor, Department of Epidemiology
    Director of ICU Research, HMC Anesthesiology

    treggmm@uw.edu

    Primary Location: Harborview Medical Center

    Professional Interests: Pathophysiology and clinical management of patients with cerebral aneurysms and subarachnoid hemorrhage, glucose management and outcomes in critically ill patients, and outcomes assessment in critically ill patients.

    UW Medicine Bio

  • Von Homeyer, Peter, MD Assistant Professor, UWMC
    Regular Faculty
    photo of faculty member

    Peter Von Homeyer, MD

    Assistant Professor,
    Anesthesiology & Pain Medicine

    peter2@u.washington.edu

    Primary Location: UW Medical Center

    Professional Interests: Cardiovascular physiology, coagulation, echocardiography, and adult congenital heart disease.

    Personal Interests: He loves to spend time outdoors with his family, cycling, mountaineering, and reading.

    UW Medicine Bio

  • Zaky, Ahmed F., MB ChB Acting Assistant Professor, VAPSHCS
    Regular Faculty
    photo of faculty member

    Ahmed F. Zaky, MB ChB

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    ahmed.zaky@va.gov

    Primary Location: VA Puget Sound HCS

    UW Medicine Bio

Current Trainees

  • Hankinson, Elizabeth E., MD CBY, Combined CCM/Anesthesiology Program
    Resident
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    Elizabeth E. Hankinson, MD

    CBY Resident,
    Combined CCM/Anesthesiology Program,
    Anesthesiology & Pain Medicine

    eeh3@uw.edu

    MD: University of Washington, Seattle, WA

  • Pennington, Matthew W., MD CBY, Combined CCM/Anesthesiology Program
    Resident
    photo of faculty member

    Matthew W. Pennington

    CBY Resident,
    Combined CCM/Anesthesiology Program,
    Anesthesiology & Pain Medicine

    mpenning@uw.edu

    MD: University of Michigan, Ann Arbor, MI

  • Kaiser, Heather, MD CA1, Combined CCM/Anesthesiology Program
    Resident
    photo of faculty member

    Heather Kaiser, MD

    CA1 Resident,
    Combined CCM/Anesthesiology Program,
    Anesthesiology & Pain Medicine

    hkaiser@uw.edu

    MD: University of Cincinnati; MPH: Johns Hopkins

  • Luk, Kevin, MD CA2, Combined CCM/Anesthesiology Program
    Resident
    photo of faculty member

    Kevin Luk, MD

    CA2 Resident,
    Combined CCM/Anesthesiology Program,
    Anesthesiology & Pain Medicine

    kluk@uw.edu

  • Le, D. Khang, MD Critical Care Fellow
    ACGME Fellow
    photo of faculty member

    D. Khang Lee, MD

    Critical Care Fellow, Anesthesiology & Pain Medicine

    khangdle@uw.edu

    Residency: UW Medicine, Seattle, WA (Anesthesiology);
    MD: UW School of Medicine Seattle, WA

  • Reich, John Adam, MD Critical Care Fellow
    ACGME Fellow
    photo of faculty member

    John Adam Reich, MD

    Critical Care Fellow,
    Anesthesiology & Pain Medicine

    joreich@uw.edu

    Residency: Tufts Medical Center, Boston, MA (Anesthesiology);
    MD: University of South Carolina Columbia, SC

  • Khandelwal, Nita, MD Senior Research Fellow, HMC
    Faculty Fellow
    photo of faculty member

    Nita Khandelwal, MD

    Critical Care Fellow,
    Anesthesiology & Pain Medicine

    khandel@uw.edu

    Primary Location: Harborview Medical Center

    Residency: Northwestern University, Evanston, IL (Anesthesiology);
    MD: Loyola University, Chicago, IL

  • Togashi, Kei, MD Senior Research Fellow, UWMC
    Research Fellow
    photo of faculty member

    Kei Togashi, MD

    Senior Fellow, Anesthesiology & Pain Medicine

    ktogashi@uw.edu

    Primary Location: UW Medical Center

    Residency: Anesthesia, Teikyo University Hospital, Tokyo, Japan
    MD: Wakayama Med. University, Wakayama prefecture, Japan
    Fellowship: University of Iowa Hosp & Clinics (Surgical ICU, Anes)
    Fellowship: University of Iowa Hospital & Clinics (CT Anes);
    Attending Anesthesiologist: Teikyo University Hospital, Tokyo

Application

Download the Critical Care Fellowship application here (pdf)

Inquiries and applications should be directed to:

For applicants from Anesthesiology, Emergency Medicine, Obstetrics, or Surgery programs, please send completed applications and/or questions to:

Kati Koszegvari
Fellowship Program Coordinator
Department of Anesthesiology & Pain Medicine
University of Washington, Box 356540
Health Sciences Bldg., BB-1440
1959 NE Pacific Street
Seattle, WA 98195-6540

phone: 206-221-6453 / fax: 206-543-2958
e-mail: katibell@u.washington.edu


For applicants from Internal Medicine programs, please send completed applications and/or questions to:

Norma Jean Schwab
Program Operations Specialist
Pulmonary and Critical Care Medicine
BB-1361 Health Sciences Bldg., Box 356522
1959 NE Pacific Street
Seattle, WA 98195-6522

phone: 206-616-8378 / fax: 206-685-8673
email: pccmfelo@uw.edu

Fellowship Director

For further information please contact:

photo of fellowship director

Dr. Steven Deem
Professor, Anesthesiology & Pain Medicine;
Program Director, Fellowship in Critical Care Medicine;
Adjunct Professor, Medicine (Pulmonary & Critical Care);
Medical Co-Director, NeuroCritical Care Service,
Harborview Medical Center

Harborview Medical Center, Box 359724
1325 Ninth Avenue, Seattle, WA 98104
Phone: 206-744-3059
Fax: 206-744-8009
Email: sdeem@uw.edu

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