Critical Care Medicine Fellowship
Robert Shapiro, MD, Program Director
Wendy Yates, Fellowship Program Coordinator
General Description and Mission
The Fellowship Program in Critical Care Medicine at Hennepin County Medical Center (HCMC) is an ACGME accredited one or two-year program. Typically the fellowship is a two-year program, unless training in an accredited subspecialty in an internal medicine program has already been completed, in which case a one-year program is acceptable. We do not accept one-year trainees into our program who are planning to enter another subspecialty, but have not yet completed their training in that subspecialty.
The program incorporates clinical activity at four hospital sites: Hennepin County Medical Center, Methodist Hospital, Fairview University Medical Center and Abbott Northwestern Hospital. Our mission is to provide an educational experience that assures its graduates will possess sound clinical judgment and a high level of knowledge in critical care medicine that will prepare them for successful passage of the American Board of Medical Specialties Critical Care Medicine examination.
Fellows and Clinical Activities
There are four total fellows; two first year fellows and two second year fellows. The one year program is entirely clinical and is designed to provide advanced training in Critical Care Medicine for individuals who have successfully completed a fellowship program in a subspecialty of Internal medicine in which skills in critical care medicine are desirable (e.g., Pulmonary, Nephrology, Infectious Diseases or Cardiology). The first year program includes rotations at HCMC MICU (3 months); Medical-Surgical ICU at Methodist Hospital, a local community hospital (3 months); Surgical ICU at Abbott Northwestern Hospital, a local community hospital (1 month); Medical ICU at the University of Minnesota (2 months); Elective (1 month); Clinical Research (1 month); and Anesthesia at HCMC for fellows who need more experience doing airway management (1 month). Call is from home but the fellow will frequently need to come into the hospital to assist the in-house medical residents. Call frequency varies, but will be approximately every third weekend and 1 or 2 nights during the week. At Methodist Hospital, there are no medical residents and the fellow will take first call (from home) for all patients and will come in to work up all new admissions. Methodist call is every other weekend and additional 6-7 weeknights each month, totaling 10-12 days per month. All rotations are structured to comply with the 80 hour per week duty hour’s policy.
The two-year program is designed for individuals who plan to practice critical care medicine as their primary specialty. The rotation schedule in the first year is identical to the one year fellowship rotation schedule. In the second year of fellowship there are 4 required clinical rotations, 2 months of elective clinical rotations and 6 months of clinical research.
The critical care fellows are closely supervised by the ICU attending physicians at all training sites. The fellow rounds on a daily basis with the ICU attending physician on every patient on the ICU service. The rounding incorporates both work and formal teaching rounds. Additional rounds occur at other times throughout the day depending upon the patient’s acuity and complexity. The supervision of the fellow is designed to provide them with appropriate backup and also to provide them with an ongoing educational experience with the philosophy that their education is best served by a combination of formal teaching and patient care done simultaneously at the bedside. The attending physician is available 24 hours a day for a consult with a fellow and is on call 24 hours a day to come to the hospital when needed for additional supervision. The fellow is encouraged to contact the attending for consultation anytime questions arise. In addition, the Program Director meets formally on a semi-annual basis with the fellows, as well as informally weekly at the scheduled core curriculum conference. The Program Director communicates monthly with site directors. The Program Director also uses results of the fellows’ evaluation of rotation and faculty as well as the internal survey to modify the program accordingly to assure that the fellows are receiving adequate supervision and support.
Fellows attend weekly critical care fellow conferences and present at least 8-9 times/year at these conferences. They are expected to present 1-2 lectures on core topics in critical care medicine in addition to presenting cases and journal club. They are also encouraged to attend the Department of Medicine Core Curriculum lectures and Grand Rounds. In the second year of fellowship the fellows will participate in a clinical research project. Fellows are expected to participate in scholarly activities and are strongly encouraged to develop a project for presentation at a national or regional scientific meeting or for publication.
A major responsibility of the fellow is supervision and education of internal medicine residents and medical students rotating on the ICU services, the exception being rotations at Methodist Hospital, where there are no residents.