Critical Care Track
From the Oregon Scholars Critical Care Chief...
Thank you for your interest in the OHSU Anesthesiology Critical Care Medicine (CCM) training program. We provide an excellent educational experience in critical care medicine under highly respected and accomplished faculty. Currently, there are two ways in which anesthesiology residents can pursue a critical care fellowship at OHSU. For trainees who are currently enrolled and are anticipated to complete, or have already completed their anesthesiology residency, we offer a traditional, one-year CCM fellowship. Trainees entering anesthesiology residency from medical school can apply for the Oregon Scholars Program (OSP), a 48-month program (not including intern year) that integrates a one-year CCM fellowship into the two final years of anesthesiology residency. OSP trainees can begin their time at OHSU either as a categorical anesthesiology intern or as a CA-1 following a preliminary or transitional internship at another program. We are proud to have the longest running combined anesthesiology-critical care medicine program in the country.
OSP CRITICAL CARE CURRICULUM
Clinical ExperienceThe OSP critical care track satisfies the ACGME requirements for both anesthesiology residency and specialty training in anesthesiology critical care. In addition to the core anesthesiology curriculum, OSP trainees will complete nine core critical care rotations, one elective critical care rotation, and three non-critical care electives to complement the critical care education. Critical care experiences are obtained primarily in three core adult intensive care units (cardiothoracic ICU, neurosciences ICU, and the Veterans' Administration surgical ICU), with elective opportunities to train in the pediatric ICUs (neonatal ICU, pediatric ICU), medical ICU, trauma ICU, and university surgical ICU. Trainees become proficient in caring for patients undergoing cardiac, thoracic, vascular, neurologic, and major abdominal surgeries, in addition to liver, heart and kidney transplantation. Trainees also work extensively in the care of patients with devastating neurologic injuries, including subarachnoid hemorrhages and strokes. Recently, our cardiac surgical ICU has combined with the institution's CCU, which has increased our experience to include non-surgical cardiac critical care patients and brings even more highly accomplished faculty into our educational experience. OHSU Knight Cardiovascular Institute continues to develop into a world-class multidisciplinary cardiovascular care center. Our ICUs are staffed with a multidisciplinary group of intensivists, which includes surgeons, anesthesiologists, neurologists, and pulmonologists, and cardiologists, creating a comprehensive education in critical care. Electives are offered in a variety of subjects to enhance the critical care training, including nephrology, infectious disease, pulmonology, heart failure, palliative care, radiology and transthoracic echocardiography, to name a few. Research opportunities are also readily available and we are in the process of summarizing all the on-going research projects and faculty interests to streamline the process for residents and fellows to find research mentors in areas they are interested in. A sample OSP schedule is included below.
OSP Sample Schedule
PGY-1 Year: 2 ICU rotations as an intern
PGY-2 Year: 2 ICU rotations as a CA-1 resident
PGY-3 Year: 2 ICU rotations as a CA-2 resident
PGY-4 Year: 3 ICU rotations as a CCM fellow
3 elective rotations as a CCM fellow
7 anesthesiology rotations as a CA-3 resident
PGY-5 Year: 6 ICU rotations as a CCM fellow
1 elective ICU rotation as a CCM fellow
6 anesthesiology rotations as a CA-3 resident
The year starts with three weeks of daily didactics in critical care topics, which then transitions to a weekly multidisciplinary lecture series, led by faculty members from a wide variety of clinical disciplines including pulmonary medicine, hematology, infectious diseases, surgery, and anesthesiology, provide fellows with a solid foundation of critical care knowledge. Once a month, this conference is replaced by a multidisciplinary critical care M&M, which brings together all critical care providers at the institution and leads to great discussions. Scholars follow this curriculum for their entire 48 month program. During monthly evening conferences, fellows present critical care topics and relevant journal articles to the anesthesiology critical care faculty and their fellow trainees. In addition, at the beginning of each year there is an echocardiography "bootcamp", where faculty and trainees come together to learn the basics of echocardiography and also get hands on experience. Our faculty are proficient in bedside echocardiography and ultrasound in the ICU and this hands-on learning is an integral part of the ICU rotations as well.
BENEFITS OF THE OSP
The Oregon Scholars Program is an innovative and exciting way for anesthesiology resident to become simultaneously confident and proficient in providing both intraoperative and post-operative care to critically ill patients. As anesthesiologists, we have a unique knowledge of the physiologic and pathophysiologic changes that occur in surgical patients, which makes us well-suited to provide post-operative critical care. Also, familiarity with the challenges of ICU management of a broad range of surgical patients allows us to plan for the post-operative course while taking care of patients in the operating room. Each complements and enhances the other, so that senior fellows are able to maintain their intraoperative skills while also enriching their critical care practice. Another benefit of the OSP CCM program is the consistent exposure to critical care didactics over the 48-month course, which builds and reinforces a knowledge base in critical care, ensuring that trainees are prepared and knowledgeable prior to starting advanced critical care rotations. An additional benefit of the program is the pairing of OSP trainees with faculty advisors from within the critical care division. The consistent mentorship throughout the 48-month program helps to integrate the junior trainees into the critical care division, and give scholars an invaluable source of career advice and planning.
This thorough, integrated training has made our graduates highly competitive when applying for jobs and additional fellowships. Previous graduates have been very successful in obtaining positions in anesthesia and critical care medicine at broad range of academic and private practice hospitals across the country, including OHSU. Others have gone on to pursue further training at prestigious programs prior to entering the work force.
Living and Working in Portland
Living in the Pacific Northwest offers many unique experiences and opportunities. For example, the restaurant scene is highly acclaimed and constantly evolving. Within an hour of the city, the ocean beaches, ski slopes, wine country and Columbia Gorge are all easily accessible.
In addition to being a level 1 trauma center, OHSU is a tertiary referral center for Oregon, SW Washington, Western Montana, Northern California and Alaska. Because of this large catchment area, our patient population is diverse and critically ill. We perform heart, liver, kidney and pancreas transplants routinely. We have a robust pediatric practice. Because of these varied patient demographics, your clinical experiences will be broad and diverse.
Another significant advantage of the Oregon Scholars Program (OSP) program is the integration with the Anesthesiology residency. Your critical care experiences will be mixed with OR rotations, and as you progress through the program you will begin to appreciate the significant complementary skills you develop in parallel for both environments.
In addition to your responsibilities as a resident, you will have opportunities to interact with a wide range of multidisciplinary critical care faculty through journal clubs, conferences and M&M. We regularly collaborate with surgeons and intensivists from other specialties, which allows for innovation and promotes a well-rounded education.
Please contact me with any questions about the program.
Andy Young, MD
Critical Care Chief 2016-2017
Oregon Scholars Program