Fellowship Training Program:
Fellowship in Critical Care Medicine

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 and Pain Medicine Department includes 15 faculty who are trained in Critical Care Medicine, and who contribute to the education of critical care fellows.

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 (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 with 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 patients requiring ICU stays. The fellow oversees a group of housestaff from Anesthesiology, Surgery and Emergency Medicine. Critical are 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.
• The Heme-Onc ICU provides exposure to bone marrow transplant and solid organ malignancy patients requiring ICU care. Fellows work one-on-one with a Pulmonary Critical Care attending in a co-management role with the hematology/oncology teams. 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.

Harborview Medical Center is the hospital for King County, and is also the only level-one trauma center in a four state region (Washington, Alaska, Montana, and Idaho, or "WAMI"). 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 is directed by the Department of Anesthesiology and Pain Medicine, and provides care for neurosurgical trauma patients with isolated spine and head injuries, and 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.
• The Trauma/Surgical ICU 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.
• The Harborview MICU Service cares for critically patients from the surrounding area and WWAMI region with medical problems. 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 nine months of core ICU rotations, electives are available in radiology, cardiology/echocardiograpy, nephrology, infectious disease, and independent study.

Applicants from anesthesiology, emergency medicine, obstetrics, or surgery programs should send completed applications and/or questions to:

Applicants from internal medicine programs should send completed applications and/or questions to: