The Critical Care Medicine Fellowship is a one-year ACGME accredited fellowship training program. Our program's goal is to train capable, independent intensivists able to care for critically ill patients in a variety of settings. We accomplish this goal through hands-on learning, graduated autonomy, didactic training, small-group experiences, and having our fellows present clinically-relevant topics in surgical critical care. In accordance with the ACGME Next Accreditation System, we aspire to have all of our fellows reach milestone Level 4 in the Critical Care Anesthesiology milestones.
Sarah U. Kumar, MD
Program Director, Anesthesia Critical Care Medicine Fellowship
Assistant Professor
Department of Anesthesiology & Critical Care
Core Rotations
The goal of the ACCM fellowship is to provide the candidate with a solid foundation in the management of critically ill adult surgical patients. To this end, fellows are required to satisfactorily complete the following core rotations:
General Surgical and Transplant Critical Care (SICU)
Duration: Three to five months
Location: Rhoads 5 and 11 Center, Hospital of the University of Pennsylvania
Director: Andrew Gold, MD, MBBS
Trauma Critical Care (TSICU)
Duration: One to two months
Location: PAC4, Penn Presbyterian Medical Center
Director: Hazel Werlhof, MD
Cardiothoracic Critical Care (HVICU)
Duration: Three to four months
Location: Heart and Vascular ICU, Pavilion 7 Hospital of the University of Pennsylvania/ PAC3 Penn Presbyterian Medical Center
Director: Jiri Horak, MD & Emily Gordon, MD, MSEd (HUP) | Noah Kornfield, MD (PPMC)
Neurocritical Care
Duration: 0.5 months
Location: Neuro ICU, Pavilion 10 Hospital of the University of Pennsylvania
Director: Michael Scott, MBChB, FRCP, FRCA, FFICM
Transthoracic Echocardiography
Duration: 0.5 months
The fellows in the SICU and TSICU manage trauma, general surgery, thoracic surgery, transplant surgery, urology, and ENT patients in a true multidisciplinary environment. The rotation in the HVICU provides clinical experience managing patients following complex cardiac procedures, heart and lung transplant, and complex mechanical circulatory support such as ECMO and VADs. Advanced didactics on the management of the neurologically impaired patient is obtained in the Neurocritical Care Unit, under the supervision of a mixed anesthesiologist / neurologist faculty.
Cardiac Critical Care Focus Pathway
In addition to the core curriculum, Penn's ACCM fellowship has designed an AGCME track dedicated to prepare clinicians for a career in Cardiac and Vascular Critical Care Medicine. With the ever increasing number, acuity, and comorbidities of patients undergoing high-risk cardiovascular surgery, there is a need to accommodate the demand for highly trained intensivists in this field of Critical Care. The additional fellowship track with a special focus on Cardiothoracic Critical Care Medicine is accessible to physicians with primary specialties of Anesthesia, Surgery, and Cardiothoracic Surgery. Clinical time in the ICU includes a minimum of 6 months in the HVICU and additional rotations through the Trauma, General Surgery ICU and electives.
Elective Rotations
To accommodate fellows' individual interests, we offer a variety of subspecialty electives that embrace the enormity of resources available within our health care system. We encourage fellows to think "outside-the-box" and work with them to design novel elective plans that will allow for a more unique and personalized training. Some examples of popular electives include:
- Emergency/Trauma ultrasonography
- Transesophageal echocardiography
- Medical critical care
- Critical care radiology and neuroradiology
- Infectious disease for the ICU
- Nephrology and renal replacement therapy in the ICU
- Palliative care and ICU hospice
- Basic, Clinical, Translational Research
- International outreach medicine
- Globalized ICU development
- Telemedicine
Didactics and Scholarly Activities
Lecture Series
As part of the educational mission of the fellowship, there are a variety of lecture series throughout the year.
- Basic course: Over the summer, there is a 9 week, 2 hours per week series of introductory lectures about basic pathophysiology and ICU management. Lectures include cardiovascular physiology, renal physiology and renal replacement therapy, ventilator management and ARDS, palliative care, nutrition and basic resuscitation for both sepsis and hemorrhage/trauma.
- Fellow lecture series: Every Thursday throughout the year, there is a lecture dedicated to advanced topics in critical care. This lecture series is multidisciplinary, featuring a number of speakers from other departments and disciplines. Included in this series are talks on ICU billing, career and financial planning, ICU administration and job and contract negotiations.
- Interdisciplinary pulmonary critical care lecture series: Held every other Friday throughout the year, fellows from anesthesia, surgical and pulmonary critical care present lectures on high-level critical care topics of their choice.
- M&M: Fellow driven. Held monthly
- Journal Club: Fellow driven. Held monthly
- Resident lecture series: As part of the core curriculum for our residents rotating through critical care, the fellows give a series of recurring lectures on basic critical care topics including sepsis, shock, neurological emergencies and ventilator management. Lecture materials are provided to the fellow.
- Ultrasound lecture series: This series includes both a basic and advanced series of lectures designed to teach TTE skills, lung ultrasound, FAST exam and vascular access.
- Cardiovascular lecture series: A weekly series on Wednesday afternoon addressing topics specific to cardiovascular critical care
- Neurocritical care lecture series: A weekly series on Tuesday mornings addressing topics specific to neurological critical care
- Fellow grand rounds: Meant to be a capstone project, each fellow presents a high level talk on a topic of their choice.
Quality Improvement Activities
The ACCM fellowship expects fellows to be engaged with quality improvement (QI) and performance improvement (PI) priorities of our health system. Fellows will be involved with initiatives across the spectrum of patient safety, health care quality, and care transition. This will occur through participation in ICU leadership meeting, quality improvement committees, participation in specific QI projects, and completion of QI/PI didactic activities provided by our office of Graduate Medical Education (http://www.uphs.upenn.edu/gme/), among others.
Application Process
The ACCM fellowship at the University of Pennsylvania participates in the SF Match www.sfmatch.org. Please make sure you have registered with SF Match and note the application deadlines listed on their website.
Required documentation to complete your application includes:
- Registration with SF Match
- Dean's letter and medical school transcript (copy)
- In-Training Examination score report (copy)
The dual or combined Critical Care Medicine and Adult Cardiothoracic Anesthesiology (2-year program) is a two-year program for achieving board certification in both Adult Cardiothoracic Anesthesiology and Critical Care Medicine with an emphasis in Cardiothoracic Surgical Critical Care. Please indicate on your application if you are interested in the dual fellowship.
Note: Please email copies of your Dean’s letter, medical school transcript, ITE score report and direct questions to the program coordinator at the following email address:
AnesAdmission@pennmedicine.upenn.edu
Jemilla Slaffey
Fellowship Program Coordinator
Department of Anesthesiology and Critical Care
University of Pennsylvania Health System