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Our program was developed with the goal of training highly competent fellows passionate about critical care medicine (CCM).
Program Highlights
- Clinical training in all aspects of medical and surgical critical care, as well as cardiothoracic surgery, cardiovascular diseases intensive care, neurosciences intensive care, and trauma intensive care
- Opportunities for research
- Potential for growth in educational, teaching, lecturing, administrative, quality improvement, and leadership skills
- Extensive education and practice in the diagnosis and management of critical care medicine and critical care procedures
- All range of diseases are managed by fellows in training
Program Components
As a fellow in our program, your rotations include:
- Eight medical ICU
- Two surgical ICU
- One neurosurgical ICU
- One cardiothoracic ICU
- One of each of the following: infectious diseases, pulmonary, nephrology, and interventional pulmonology
- Four night float rotations
- Four scholarly project rotations
- Two elective rotations (critical care ultrasound, transesophageal echocardiography, burn unit, renal transplant, liver transplant, or cardiac transplant)
- Post-Critical Care Clinic
Fellow education is a high priority for the Division of Pulmonary, Critical Care, and Sleep Medicine. Your training is aided by various didactics, conferences, and simulation sessions.
- Didactic training includes teaching sessions, conferences, and lectures
- Experiential learning within the Procedural Skills Laboratory
- Orientation: Faculty-driven lectures and simulations on essential critical care topics
- Core curriculum lectures (twice weekly): Fellows lead discussions in various relevant basic science, histopathology, radiology, and clinical conferences
- MICU Morbidity and Mortality Conference
- Monthly Journal Club
- Various faculty-driven subspecialty curricula
- Critical Care Grand Rounds
- Simulations including bronchoscopy, pleural procedures, airway management, PA catheters, percutaneous tracheostomy, and ventilators
- Critical Care Ultrasound Symposium, provided by ultrasound experts from various disciplines
- Fundamental Critical Care Support – certification provided by the Society of Critical Care Medicine
- Annual symposia on pulmonary and critical care topics
- Extensive reading and other educational materials are made available
About one-third of your training period is spent in various research activities. Fellows are expected to engage in at least one original investigation and one quality improvement (QI) project.
- Year 1: Identify mentor and research project, complete design, protocol, and IRB application. Identify QI project and faculty supervisor.
- Year 2: Study implementation, study completion, and presentation
Our fellowship program offers a broad experience in intensive care through rotations on the medical intensive care unit (MICU), surgical intensive care unit (SICU), neurological-multidisciplinary critical care service (NMCCS), and cardiothoracic intensive care unit (CTICU).
Curriculum focus by year
- Year 1: eight months of ICU rotations (two of night float), two months of research, two months of consultation services, one month of elective.
- Year 2: eight months of ICU rotations (two night float), two months of research, two months of consultation services, one month of elective.
Inpatient Pulmonary Consultation
Fellows have approximately four pulmonary consult months over the two-year fellowship. You are expected to lead the inpatient consult team at Loma Linda University Medical Center. You'll become proficient at evaluation and management of a myriad of pulmonary disorders and hone your skills performing and interpreting pulmonary function and cardiopulmonary testing, lung and pleural ultrasound, and a number of interventional pulmonary procedures. You'll also participate in our busy hyperbaric medicine practice while on consult at the Medical Center.
Critical Care
Fellows gain experience in the evaluation and management of a wide variety of advanced critical illnesses, typical of a tertiary care referral center. You become versed in delivering advanced mechanical ventilation, interpreting both invasive and non-invasive monitoring, performing critical care procedures, and using critical care ultrasound. You will also be expected to supervise and teach residents in all facets of ICU care.
Electives
Elective options include burn ICU, cardiology, echocardiograpy, infectious disease, and interventional pulmonology rotations.
- Thoracic Oncology Clinic (TOC): Fellows evaluate and manage lung nodules, masses, thoracic adenopathy, and lung cancer.
- Pulmonary Hypertension Clinic (PHC): Fellows diagnose, grade, and manage complex pulmonary vascular disease of various causes.
- Post-Critical Care Clinic
The type and expected volume of procedures over your two-year training are as follows:
- Bronchoscopy: 50
- Thoracentesis (with pleural manometry): 50
- Thoracostomy tubes: 20
- Tunneled indwelling pleural catheters: 10
- Endotracheal intubation (laryngoscopic and bronchoscopic): 75
- Percutaneous dilational tracheostomy: 20
- PA/right heart catheters: 10
- Central and arterial lines: 100