Transcript Fellowship - UC San Diego Department of Anesthesiology

Anesthesiology Critical Care Medicine Fellowship
at the University of California, San Diego
…… A Unique Educational Experience
in America’s Finest City……….
4 Educational Sites
UCSD Thornton Hospital
UCSD Medical Center, Hillcrest
Sulpizio Cardiovascular
Center
Jacobs Medical Center
(Opening 2016)
Clinical ICU Training
• Thornton Hospital: 12 Bed Medical/Surgical
ICU
• Sulpizio Cardiovascular Center: 12 Bed
CCU/Thoracic-Cardiovascular Post Op Unit
• UCSD Medical Center, Hillcrest: 20 Bed
Surgical Trauma ICU, 8 Bed Burn ICU, and
a dedicated Neurosciences Critical Care
Unit
• Additional Opportunities for expansion
include: Jacobs Medical Center (2016,) VAICU, Rady Children’s PICU
Critical Care Faculty
Erik Kistler, MD, PhD – Director of Research
Medical School: George Washington University, Anesthesiology Residency: UCSD, CCM Fellowship: MGH
Interests: Sepsis and Shock (Mechanisms, Diagnosis, and Treatment)
Brian Lemkuil, MD
Medical School: Loma Linda, Anesthesiology Residency: UCSD, CCM Fellowship: UCSD/Cambridge
Interests: Cerebral Blood Flow, Subarachnoid Hemorrhage, Cerebral Vasospasm
Zeb McMillan, MD
Medical School: University of Iowa, Anesthesiology Residency: Advocate Illinois Masonic Medical Center (Chicago)
CCM Fellowship: UCSF
Interests: Venous Blood Gas Analysis, Ventilator Synchrony, Pain and Sedation in ICU, RBC transfusion
Angela Meier, MD, PhD
Medical School: Ludwig Maximlans University (Munich), Anesthesiology Residency: MGH, CCM Fellowship: MGH
Interests: Sepsis, Trauma, Immunologic Impact of Anesthesia
Critical Care Faculty
Anushrivan Minokadeh, MD – Division Chief
Medical School: LSU, Anesthesiology Residency: SUNY Downstate Hospital, CCM Fellowship: Johns Hopkins
Interests: Neurocritical Care, Liver Transplantation, Resuscitation Science, Quality and Performance Improvement
Beverly Newhouse, MD – Education Director
Medical School: University of North Carolina, Anesthesiology Residency: UCSD, CCM Fellowship: MGH
Interests: Medical Education, Mechanical Ventilation & Weaning, Resuscitation Physiology
Albert Nguyen, MD
Medical School: University of Colorado, Anesthesiology Residency: UT Southwestern, CCM Fellowship: UCSD
Interests: Coagulopathy and Coagulation Monitoring
E. Orestes O’Brien, MD – Clinical Chief
Medical School: Harvard, Anesthesiology Residency: UCSF, CCM Fellowship: MGH
Interests: Monitoring and hemodynamic optimization
Critical Care Faculty
Kimberly Robbins, MD-Fellowship Director
Medical School: University of Virginia, Anesthesiology Residency: UCSD, CCM Fellowship: UCSD
Interests: Obstetric Critical Care, Echocardiography, Education
Ulrich Schmidt, MD, PhD, MBA
Medical School: University of Munich, Anesthesiology Residency: MGH, CCM Fellowship: MGH
Interests: Care of the Critically Ill patient in OR and in the ICU, Optimization of high risk interventions in the ICU
Christopher “Kit” Tainter, MD, RDMS
Medical School: University of Washington, Emergency Medicine Residency: Mount Sinai NY, CCM Fellowship: MGH
Interests: Point of Care Ultrasound, Resuscitation, Cardiac Arrest, Education
Educational Overview:
Core and Elective Rotations
• The ACGME requires all fellows in Anesthesiology
Critical Care Medicine to complete 9 months of adult
critical care.
• Each fellow will spend approximately 7 months in the
Thornton & Sulpizio CVC ICU. The patient population
consists of complex Cardiovascular, Thoracic,
Neurosurgical, General Surgical, Urologic, Gynecologic,
& Orthopedic Patients.
• Fellows may complete their additional critical care
requirement in the neuro, medical, burn, or surgical/
trauma ICUs.
Educational Overview:
Core and Elective Rotations
• Fellows spend a total of 3 months of elective time
either on corollary services with relevance to
critical care (e.g. Infectious Disease, Cardiology,
Palliative Care,) or completing original research
• Individualized electives may also be developed by
the fellow
• Fellows are expected to complete both an
academic project and a quality improvement
project during the year
Educational Overview (cont.).
Expectations & Goals
• The primary goal of the core fellowship training is to
provide the fellow with clinical experience in the
management of critically ill surgical and medical patients.
• Fellows will gain extensive experience managing heart
and lung transplant patients, ventricular assist devices,
total artificial heart, and extracorporeal circulation.
• Our fellows also develop expertise in coordinating a
multidisciplinary team, and in all of the common
procedures used in CCM.
• Training in Echocardiography & Bronchoscopy will be
specifically emphasized & provided to all fellows.
Echocardiography Training
• Our flourishing
cardiovascular program
provides our fellows with
opportunities to become
proficient in both TTE and
TEE.
• Bedside teaching as well as
electives in both modalities
are available.
• Fellows will attend the 3 day
UCSD Perioperative TEE
Review Course/Conference
at no charge
Fiberoptic Bronchoscopy
(FOB) Training
• FOB Training and experience is one
of the Core CCM Procedures that will
be mastered by ACCM Fellows.
• All Faculty are proficient in FOB use
and teaching.
• In addition, Dr. Jonathan Benumof,
“originator of the ASA Difficult Airway
Algorithm”, will teach FOB
techniques in his Difficult Airway Lab.
• An Airway Simulator is available.
• All Fellows will become expert
bronchoscopists.
Research Opportunities
• All Fellows will participate in clinical research
including planning of a project, production of
IRB proposal, and eventual presentation of
research findings.
• Research topics explored by previous fellows
include:
• Effect of positive pressure ventilation on
diastole as measured by echocardiography
• Effect of blood transfusion on SVO2 in postcardiac surgery patients
• Long-term outcomes following SICU
Admission
• CCM Faculty will closely assist the fellows in all
aspects of research.
Current Research
Projects
• Dr. Kistler – Analysis of the changes in hemodynamics and
oxygen delivery in response to blood transfusions in the ICU.
Shock and inflammation, with particular focus on the bowel.
• Dr Meier - Investigations on how sedatives and pain
medications modify the immune response.
• Dr. Nguyen – Long Term Outcomes Following Surgical ICU Stay.
• Dr. O’Brien - Investigating the effects of neuraxial
sympathectomy on cardiac function in term parturients.
• Dr. Schmidt – Investigating the value of high intensity interventions
in the critical care setting.
Eligibility Criteria and
Application Process
The Eligibility Criteria For ACCM Fellowship are as follows:
•
Board certification (or eligibility) in Anesthesiology by the ABA (or
equivalent if non-American trained.)
•
Possess (or be eligible for) a California medical license (must have
current license in State of Residence at time of application.)
Have certification in ACLS (or equivalent.) ATLS is also advised.
Application Process
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UCSD currently has 3 fellowship positions available beginning July 1.
We participate in the SF Matching Program: www.sfmatch.org
Applications typically open in November, with the match occurring in
May one year prior to start date.
Applicants interested in a combined experience in CCM and Adult
Cardiothoracic Anesthesia should apply to both programs individually
and alert both program directors of your intent.
ACCM Fellowship Contact Information
Julie Nguyen, ACCM Fellowship Coordinator
Department of Anesthesiology and Critical Care
University of California, San Diego
200 West Arbor Drive, #8770
San Diego, CA 92103-8770
Phone (619) 543-6240
Fax: (619) 543-6476
[email protected]