Critical Care Medicine fellows play a key leadership role on our multidisciplinary ICU teams as they rotate through a diverse range of medical, surgical, and subspecialty intensive care units. Fellows spend approximately eight months in medical and four months in non-medical ICUs over the course of the two year fellowship, providing broad exposure to the full spectrum of critical illness. At Bridgeport Hospital, fellows train in the Medical, Surgical, and Burn ICUs. In the Medical ICU, fellows manage a wide variety of medical, cardiovascular, and neurologic critical illnesses while working closely with critical care faculty and internal medicine residents. The Surgical ICU provides extensive experience in the management of traumatic injuries, acute care surgical conditions, and complex postoperative patients. Fellows also care for patients with severe burn injuries in Connecticut's only dedicated Burn ICU.
Fellows rotate through additional subspecialty ICUs at Yale New Haven Hospital, including the Medical, Cardiac, Cardiothoracic Surgical, and Neurocritical Care ICUs. These rotations provide unique exposure to multidisciplinary critical care environments across the Yale New Haven Health System, and exposure to advanced therapies such as transplant and mechanical circulatory support including extracorporeal membrane oxygenation (ECMO).
A wide variety of elective rotations round out the training experience. Elective rotation options include pulmonary medicine/bronchoscopy, anesthesiology, palliative care, echocardiography, emergency medicine, and other medical subspecialties.
Fellows will rotate with the pulmonary section during their elective time to enhance their experience in bronchoscopy and pulmonary management of common conditions in the hospital setting.
Fellows will also undergo Point of Care Ultrasound (POCUS) training through a structured program including a state-wide ultrasound symposium and training twice a year; monthly didactics and hands-on training for POCUS at the bedside.
Research blocks are provided for trainees to have meaningful opportunities for clinical and research scholarship. Fellows are encouraged to attend regional and national meetings to present their work.
The Section of Critical Care and Sleep Medicine has a robust conference schedule, and both faculty and fellows participate in the didactic program. In the early months of each academic year, faculty provide an introductory core lecture series that covers foundational topics in critical care medicine, with an emphasis on a practical approach to patient care and critical appraisal of literature. Faculty lectures continue throughout the year, amidst a weekly journal club, topic and case-based conferences, research conferences and a monthly morbidity and mortality conference. Multidisciplinary conferences with radiology enhance chest radiology exposure. Fellows are expected to prepare numerous case-based presentations over the course of their training with a focus on utilizing the published medical literature to help guide their approach to clinical care, while laying the foundation for life-long learning beyond fellowship.
Simulation education for procedural training; airway simulations and case-based simulations for critical care education are also integrated into the didactic program. These sessions are conducted throughout the year and include multi-disciplinary simulations with nursing and advance practice providers to enhance the critical care learning and experience.
The medical intensive care unit is a 16-bed unit capable of the full support of the critically ill patient. We have bedside ultrasonography for line placement, pleural procedures, and critical care echocardiography. The fellows have ample opportunity for performing the standard ICU-related procedures including the insertion of central venous catheters, arterial lines, thoracentesis; chest tube placement and intubations.
The Surgical ICU and Burn Unit are also independent ICUs, offering an additional 22 critical care capable beds to full support management of traumatic injuries, acute care surgical conditions, and complex postoperative patients including burn patients.
Fellows rotate at Yale New Haven Hospital in the Medical ICU, Neurosciences ICU, and cardio-thoracic ICU, under the supervision of the Yale School of Medicine faculty and alongside Yale co-fellows, residents, and medical students. Yale New Haven Hospital is a large university referral center and includes a busy 40-bed MICU that has over 4,500 admissions per year alongside its subspecialty ICUs, where fellows experience with complex neurologic, hematologic and oncologic diseases, solid and liquid organ transplant, mechanical circulatory support including ECMO, as well as respiratory disorders in the critical care setting less commonly seen in the community hospital, such as cystic fibrosis and interstitial lung disease.
The Section of Pulmonary, Critical Care and Sleep Medicine maintains and encourages fellow participation in an active clinical research and patient care quality improvement effort. Fellows are expected to develop and produce substantive works of clinical scholarship and can take the form of published abstracts, peer-reviewed manuscripts, quality improvement and patient safety initiatives. Fellows are expected to attend regional and national meetings, such as the Society for Critical Care Medicine, Connecticut Thoracic Society, American Thoracic Society and the American College of Chest Physicians to present their works of scholarship and learn from the broad array of scholarship being performed by others in our field.
