Education

Fellows

Duke Anesthesiology has been offering an ACGME-accredited fellowship in critical care medicine since 1994. In addition to retaining full accreditation status, the program was awarded a special commendation recognizing the development and implementation of innovative web-based modules for the education and evaluation of critical care fellows. The fellowship continues to attract a number of strong applicants. Additional training in transesophageal echocardiography (TEE) is now offered to critical care fellows in collaboration with the fellowship program in cardiothoracic anesthesiology.

Residents

First-year residents in anesthesiology are introduced to critical care medicine at the VAMC SICU. Here they have an opportunity to learn the skills needed to care for critically ill post-operative patients and those patients requiring intermediate levels of care.

Additional training in critical care medicine for CA-2 residents in anesthesiology is provided in the 24-bed SICU at DUMC (6WestDMP). Residents gain additional experience in managing complex patients in this busy trauma/post-surgical unit. One of the unique features that distinguish the Duke critical care experience for the residents in 6West DMP is the presence of attendings, staffed by the Departments of Anesthesiology and Surgery. The varied backgrounds and training of the attending physicians allows the residents to gain multiple perspectives in the treatment of critical illness. The clinical and didactic components of this rotation are maintained at high levels with the input of the critical care fellows and attending staff.

CA-3 residents can choose to spend additional time in the DUMC SICU during their final year of training. During this time, senior residents have gained additional experience in managing complex ICU patients while acquiring more responsibility for daily rounds, decision-making, and education of junior members of the SICU team. Opportunities for training in TEE are also offered to senior residents during this elective rotation.

Medical Students

Instruction to medical students in intensive care medicine is offered through the Duke University School of Medicine. A month-long rotation in SICU is available to fourth-year medical students from Duke and other institutions (both national and international). Students enrolled in this course take part in daily rounding in the SICU at Duke University Medical Center. After an initial introduction to critical care medicine, they participate in the care of critically ill patients by evaluating and presenting patients on SICU rounds, and taking in-house call with the residents. The students frequently cite the experience in managing complex medical problems and enthusiastic teaching by residents, fellows and attendings as strong positives of this course.

With the recent re-structuring of the curriculum at the School of Medicine, a new critical care intersession (“Clinical Core”) has been instituted. This course is designed to give medical students a brief introduction to acute, in-hospital care early in their medical education. One-hundred, second-year Duke medical students are instructed by members of the Critical Care Medicine Division in the methods of critical care during the Clinical Core. Day one of this seminar is devoted to the presentation of a case to the students, followed by small group discussion of critical care issues raised by the case presentation. During the next two days, the students are given the opportunity to make rounds in the Duke SICU with Critical Care Medicine attendings and explore related technologies such as invasive hemodynamic monitoring and mechanical ventilation. A month-long elective in critical care medicine is available for those students who wish to further advance their knowledge.