Critical Care Fellowship

Staney Rosenbaum, MD, Director

The critical care fellowship is designed to provide a multidisciplinary exposure to the care of critically ill patients and to offer adequate opportunity for research experience. We seek aspiring academic anesthesiologists with strong interests in clinical care and research. The fellowship also includes some intraoperative anesthesia experience. Board Certification/Eligibility in Anesthesiology is required, and additional background in Internal Medicine or Surgery is strongly preferred.

The critical care anesthesiology fellow is expected to serve for about eight months in the SICU of the Yale-New Haven Hospital of the Y-NHH, and has three-four months of elective time in the other ICUs of Y-NHH (this includes PICU, NICU, and MICU). Up to two months of elective time can be in non-ICU settings, including operating room anesthesiology or the various clinical or research laboratories of the Medical Center.

While in the SICU, the critical care anesthesiology fellow is part of a multidisciplinary fellowship team that includes two surgical critical care fellows, and frequently a pulmonary medicine fellow as well. At any given time, two surgery/anesthesiology fellows are on-service in the SICU and one is on elective away. One of the two fellows on the SICU serves as the “clinical fellow” and runs the service, and the other is the "education" fellow responsible for conferences, teaching, research and administrative issues. All fellows share night and weekend call for the SICU. The fellow on service has administrative control of SICU bed availability for elective and emergency surgery, acting in concert with the ICU nurse manager and the on-service faculty member. The fellow, in conjunction with the SICU faculty member, is also responsible for critical care consultation requests that come to the SICU service. These include patients with complex problems on the Neurosurgical service, and patients (generally from surgical subspecialties) who are critically ill on the Medical Service.

There are daily formal morning faculty rounds on all patients and formal weekday afternoon rounds. Faculty assigned to the unit do not have other clinical responsibilities, are based in offices near the ICU, and are available for discussion on a 24-hour basis.

The fellow supervises a team that includes residents from Surgery, Anesthesiology and Emergency Medicine, plus medical students, and regular participation by dieticians, pharmacists and social service workers.

Additional surgical trauma faculty are part of our service and are in the hospital 24 hours/day for urgent onsite backup.

Educational activities in the SICU include extensive daily teaching and clinical rounds, frequent short teaching sessions, weekly formal teaching conferences, weekly M&M rounds, monthly formal interdisciplinary QI conferences, and quarterly formal ethics conferences.