critical Care

Critical Care Only Fellowship

The University of Washington Division of Pulmonary and Critical Care Medicine offers select positions for dedicated clinical training in Critical Care Medicine.

A one-year Critical Care Medicine fellowship is aimed at physicians who have completed or plan to complete a full ABIM fellowship in another Internal Medicine sub-specialty (e.g., Nephrology, Infectious Disease, Cardiology, etc.). When combined with another fellowship program, this twelve-month clinical experience confers eligibility to sit for the Critical Care Medicine board examination. 

A two-year Critical Care Medicine fellowship is also available for graduates of Internal  Medicine residencies and graduates of Emergency Medicine residencies who have not completed another ABIM fellowship. Two years of fellowship is necessary for such physicians to sit for the Critical Care Medicine board examination.

Clinical Curriculum:

Fellows rotate through a broad mix of ICUs within the UW system in a schedule that it is integrated with the Pulmonary Critical Care and Anesthesiology Critical Care fellowships.

Fellows split their time between three Seattle clinical sites: 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.

The University of Washington Medical Center (UWMC) is a quaternary referral center that provides advanced services such as solid organ and bone marrow transplantation, advanced oncology care, and complex cardiovascular surgery. It offers fellows several ICU services:

  • The Medical ICU (MICU) Service cares for a variety of patients, including post-operative liver transplant and long-term lung-transplant patients, as well as general medically ill patients. The fellow guides a team of housestaff composed of interns and Internal Medicine R2s and Emergency Medicine R3s with oversight by faculty from the Division of Pulmonary and Critical Care Medicine. The fellow takes the calls for outside transfers from throughout the Pacific Northwest, and is responsible for triaging transfers. An in-house hospitalist covers the service overnight.
  • The Surgical ICU (SICU) Service cares for post-operative surgical patients from General Surgery, Neurosurgery, Otolaryngology, Urology, Plastic Surgery, Orthopedics, and, in some cases, Obstetrics and Gynecology. The fellow oversees a group of housestaff from Anesthesiology, General Surgery and Emergency Medicine. The service is led by Critical Care-trained faculty from General Surgery, Anesthesiology and Pulmonary and Critical Care. An in-house hospitalist covers the service overnight.
  • The Cardiothoracic ICU (CT 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, Advanced Practice Providers, Pharmacists, and Dietitians. 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 extracorporeal life support (ECLS) and mechanical circulatory support program. The Critical Care faculty on this service are dual-trained in Cardiac Anesthesiology and Critical Care, or in Cardiothoracic Surgery and Critical Care. There is no overnight call.
  • The Oncology-Bone Marrow Transplant (Onc-BMT) ICU provides exposure to bone marrow transplant, leukemia, and solid organ malignancy patients requiring ICU care. Fellows work with an advanced practice provider and Pulmonary Critical Care attending to manage a cohort of critically ill cancer patients and provides inpatient consultative services for oncology patients on the regular wards with pulmonary issues. 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. An in-house hospitalist covers the service overnight.

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

  • The Neurocritical Care Service (NCCS) provides care for neurosurgical trauma patients with isolated spine and head injuries, patients with a variety of neurovascular problems such as subarachnoid hemorrhage and neurology patients requiring ICU care. Fellows work with housestaff from Anesthesiology, Emergency Medicine, Neurology, and Neurosurgery, and faculty from Anesthesiology and Pulmonary and Critical Care. Call on this service is from home.
  • The Trauma/Surgical ICU (TICU) 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 and Critical Care, and Trauma Surgery. Fellows have the opportunity to take in-house call one day per week, during which they are able to participate in major trauma resuscitations in the emergency department.
  • The Harborview Medical ICU (MICU) Service cares for critically ill patients from the surrounding area and WWAMI region with medical problems. Residents on this service are from Internal Medicine, and faculty are from Pulmonary and Critical Care. Call on this service is from home.

The Veterans Affairs Puget Sound Health Care System - Seattle Division, provides primary and tertiary care to veterans from the Pacific Northwest. Fellows rotate through the following service:

  • The Medical ICU Service cares for a wide variety of veterans with acute critical illness as well as severe exacerbations of chronic disease. Fellows supervise a team comprised of Internal Medicine housestaff and advanced practice providers. Faculty are from Pulmonary and Critical Care Medicine.

In addition to nine months of core ICU rotations in the first year, electives are available in radiology, cardiology, echocardiograpy, pulmonary medicine, ultrasound, airway management, nephrology, infectious disease, and research/quality improvement. More elective time is available in the second year for fellows completing the two-year curriculum.

Sample Schedule:

 

Year 1*

Year 2**

Jul

CT ICU

NCCS

Aug

Onc BMT ICU

Elective

Sep

Elective

HMC MICU

Oct

VA MICU

Elective

Nov

UWMC MICU

TICU

Dec

HMC MICU

Elective

Jan

Elective

Pulmonary

Feb

NCCS

UW SICU

Mar

TICU

Elective

Apr

Elective

Nephrology

May

VA MICU

CT ICU

Jun

UWMC SICU

Elective

*Completed by 1-year and 2-year fellows
**Completed by 2-year fellows only

Didactic Curriculum:

A number of didactic opportunities are available to fellows. Fellows present cases (in rotation with fellows from Pulmonary-Critical Care and Anesthesiology Critical Care) to faculty discussants at the weekly Seattle Area Chest Grand Rounds, one of the UW health system’s most popular conferences. Weekly core content lectures on a variety of topics relevant to critical care medicine follow. Conference time is protected for fellows, unless extreme clinical circumstances mandate otherwise.

A variety of other educational opportunities occur at the various teaching sites. These include daily teaching rounds in all ICUs (which are regularly led by either the fellow or attending physician), Harborview’s weekly Multidisciplinary ICU journal club, weekly UWMC ICU conference, monthly Pulmonary-Critical Care journal club, Seattle Resuscitation Grand Rounds, and a host of research journal clubs.

Application:
The Critical Care Medicine fellowship accepts applications via the Electronic Residency Application Service (ERAS), but does not participate in the National Residency Matching Program.

Vacation, Stipends, and Benefits:

All fellows receive three weeks of vacation. Information on stipends and benefits can be found on the UW GME website: http://www.uwmedicine.org/education/gme/residents-fellows

Contact Information:

Norma Jean Schwab
Fellowship Program Coordinator
University of Washington Box 356522
Seattle, WA 98195-6522
(206) 616-8378
FAX (206) 685-8673
pccmfelo@uw.edu

Andrew M.  Luks, MD
Associate Professor
Fellowship Program Director
Department of Medicine
Division of Pulmonary and Critical Care Medicine
325 Ninth Avenue Box 359762
Seattle, WA 98104
aluks@u.washington.edu



 

top of page