University of Arizona

Program Description

Type of Program
This is an ACGME accredited critical care medicine fellowship program through the Department of Medicine, Section of Pulmonary, Critical Care, Allergy, and Sleep co-sponsored with the Department of Emergency Medicine. This program meets the requirements to sit for the ABIM critical care medicine board exam. At the completion of the fellowship, graduates will have the knowledge, skill set, and administrative experience to be proficient in the care of patients, supervision of trainees, and medical direction of medical or surgical ICUs.

Year Fellowship Started: 2010

EM-CCM Program Status
Department of Internal Medicine, Section of Pulmonary/ Critical Care

Application Method & Deadlines
Interested applicants should submit their CV and letter of interest to Dr. Jarrod Mosier, Associate Program Director jmosier@aemrc.arizona.edu near the end of their 2nd year (3rd year if 4-year program).

Application Requirements

Candidates must be a graduate of a certified ACGME program in Emergency Medicine.
Candidates should complete a formal on-site interview on an invitation basis.
Candidates should submit the following information for application:
Current curriculum vitae
Letter of interest in training in critical care medicine
Recent photograph
Copy of USMLE scores
Copy of ECFMG certificate (if applicable)
Copy of medical school transcript and diploma
Three letters of recommendation (one from program director, and at least one from an intensivist)

Number of Fellows per year
1

Length of Fellowship
2

Primary Training Site Demographics
   Number of Hospital Beds: UAMC University Campus: 466
UAMC South Campus: 150

   Number of ICU Beds: UAMC University Campus: ~80 adult critical care beds
UAMC South Campus: ~13 adult critical care beds 


   ED Annual Visits: UAMC University Campus: 73,000
UAMC South Campus: 40,000

Affiliated Sites
University of Arizona Medical Center University Campus
University of Arizona Medical Center South Campus
Southern Arizona VA Medical Center

EM-CCM Fellowship Education
Upon completion of his or her fellowship program, the fellow will be able to independently perform care in the ICU and also be adequately versed in the indications, contraindications, techniques, strengths and limitations of each procedure and the management of any complications. Fellows will learn the tenets of stabilization of critically ill patients and understand the differential diagnoses and appropriate diagnostic evaluations of such patients. They will both lead and function within interdisciplinary teams to provide care that is timely, appropriate, and takes into account patient or family preferences. The humanistic and caring concern for each patient and family and his or her problem is an essential component of taking care of patients in the ICU.

Each fellow is expected to participate in quality improvement activities related to the care of critically ill patients. The varied interests of the faculty afford the fellow exposure to a wide variety of investigative opportunities. Current clinical areas of interest include quality improvement projects regarding sepsis, ICU delirium, airway management and safety and critical care ultrasound in shock.

Sample Curriculum
Curriculum
The fellowship in critical care medicine is an ACGME accredited, diversified, intensive two-year experience in all aspects of critical care that prepares the trainee for the ABIM/ABEM Critical Care Medicine board exam. The curriculum includes a weekly mandatory didactic conference, a mandatory monthly multidisciplinary conference, a monthly Morbidity and Mortality ICU conference, journal club, and multiple lectures and simulation lab sessions throughout the fellowship. Fellows will gain proficiency in the evaluation and management of critically ill and injured patients with medical, surgical, traumatic, and neurologic diseases. This will include, but not be limited to, the following:

Evaluation and management of acute and chronic respiratory failure: differential diagnoses, ventilator management and diagnostic approaches. This includes evaluation and management of patients with:

o Acute respiratory distress syndrome
o Acute and chronic respiratory failure in obstructive lung diseases
o Neuromuscular respiratory drive disorders
o Acute lung injury due to trauma
o Invasive and non-invasive modes of ventilation

Evaluation and management of:

o Circulatory and shock disorders including septic, cardiogenic and hypovolemic shock
o Cardiovascular diseases including ischemic heart disease, sepsis and sepsis syndromes, hypertensive emergencies
o Multi-organ failure
o Acute metabolic disturbances and electrolyte and acid-base disorders
o Inhalation or radiation induced lung injury
o Infections in the immunosuppressed patient
o Anaphylaxis and acute allergic reactions
o Respiratory failure including ARDS, acute and chronic respiratory failure in patients with obstructive and restrictive lung diseases, and in those with neuromuscular respiratory drive disorders
o Use of paralytic drugs and sedative and analgesic medications
o Hemodynamic and ventilatory support of patients in the post-operative period
o Overdoses and intoxication syndromes
o Metabolic, nutritional and endocrine effects of critical illness,
o Hematologic and coagulation disorders associated with critical illness
o Detection and prevention of iatrogenic and nosocomial problems in critical care medicine
o Psychosocial and emotional effects of critical illness on patients and families
o Management of end of life issues and palliative care
o Evaluation and management of patients with neurosurgical and trauma emergencies
o Critical obstetric and gynecologic disorders.
o Trauma
o Neurosurgical emergencies
o Obstetric and gynecologic disorders
o Evaluation and management of patients after discharge from the ICU.
o Evaluation and management of patients with disorders of the cardiovascular, respiratory, renal, gastrointestinal, genitourinary, neurologic, endocrine, hematologic, musculoskeletal, and immune systems.
o Evaluation and management of infectious diseases in the ICU.
o Basic and Advanced cardiopulmonary resuscitation
o Procedures: Fellows have the opportunity to perform and supervise a variety of critical care procedures including arterial lines, central venous lines, pulmonary artery catheterization, endotracheal intubation, bronchoscopy, chest tube placement, thoracentesis, paracentesis, lumbar puncture, and percutaneous tracheostomy.

Listing of Graduates & Years
Jarrod Mosier: First Program Fellow and Graduate- 2012 (ABIM/ABEM Critical Care Medicine Board Certification obtained 2012)
Eric Chase: Second Program Fellow and Expected Graduation- 2013
Sage Whitmore: Third Program Fellow and Expected Graduation- 2014

Program Website
http://deptmedicine.arizona.edu/pulmonary-fellowship/conference_schedule

http://emergencymed.arizona.edu/fellowships/critical-care