Critical Care Track

From the Oregon Scholars Critical Care Chief...

Olsen - OSP Chief Resident

Dear Prospective Residents and Fellows,

Thank you for your interest in the OHSU Anesthesiology Critical Care Medicine (CCM) program. OHSU offers outstanding clinical training in critical care medicine from a diverse and accomplished faculty, and a collaborative working environment, all while enjoying everything that Portland and the Pacific Northwest have to offer. 

Critical care fellowship at OHSU can be pursued in two ways. We offer a traditional one-year CCM fellowship for applicants who are completing their anesthesiology residency. For those who are first applying to residency, we offer the Oregon Scholars Program (OSP) critical care track, a 48-month program that integrates a one-year CCM fellowship into the final two years of anesthesiology residency. Each year, two OSP critical care positions are offered through the Match: one categorical and one advanced. We are proud to have been the first combined anesthesiology-critical care medicine program in the country. 

Critical Care Curriculum at OHSU

OSP Combined Residency &Fellowship Track: Upon completion of the OSP critical care program, graduates meet ACGME requirements for board eligibility in both anesthesiology and anesthesiology critical care. In addition to the core anesthesiology curriculum, OSP fellows complete nine core critical care rotations, one elective critical care rotation, and three elective rotations.

Traditional Fellowship Track: During their first month, traditional fellows complete an orientation rotation where they spend a week on each of our three core adult ICUs. Subsequently, they complete nine core critical care rotations and three elective rotations.

Critical care experiences are obtained primarily in our three core adult intensive care units: OHSU's Cardiovascular ICU and Neurosciences ICU, and the Portland Veteran's Administration Surgical ICU, all of which have anesthesia intensivists as medical directors. Elective opportunities are available in the medical ICU, trauma and surgical ICU, and pediatric ICU. 

OHSU is a Level 1 Trauma Center and a quaternary referral center for Oregon, southwest Washington, northern California, and Alaska, resulting in a diverse and high acuity patient population.

Throughout the course of their training, our fellows get extensive experience in the post-operative care of patients undergoing cardiac, thoracic, vascular, neurologic, major spine, and major abdominal operations, in addition to heart and liver transplants. In the neurosciences ICU, fellows become comfortable caring for critical neurologic illnesses including hemorrhagic and embolic strokes, seizures, and neuromuscular disorders. Additionally, the cardiovascular ICU cares for non-surgical cardiac critical care patients and critically ill obstetric patients. Through this, fellows gain proficiency in caring for STEMI, malignant arrhythmias, advanced heart failure, LVAD and post cardiac arrest patients.  We have a growing adult ECMO program at OHSU, with both V-A and V-V ECMO, as well as an ECMO transport program. 

Our intensive care units are staffed by a multidisciplinary group of intensivists, including anesthesiologists, surgeons, neurologists, pulmonologists, and cardiologists, fostering a comprehensive critical care education. 

A variety of electives are offered, including heart failure, transthoracic echocardiography, radiology, pulmonology, infectious disease, nephrology, and palliative care. Research opportunities are readily available, and we work to identify potential research mentors early in the fellowship. 

Our faculty, staff, and residents genuinely enjoy working together, support each other, and create a very welcoming environment in which to train. 

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 rotations as a CCM fellow

                     6 anesthesiology rotations as a CA-4 resident

Traditional Fellow Sample Schedule

PGY-5 Year: 1 orientation rotation

      9 ICU rotations as a CCM fellow

                     3 elective ICU rotations as a CCM fellow

Didactic Experience

The academic year starts with three weeks of daily didactics in core critical care topics, which then transitions into a weekly multidisciplinary lecture series to provide fellows with a solid foundation of critical care knowledge. Additionally, multidisciplinary critical care M&M occurs once per month, which brings together critical care providers from all disciplines. During monthly afternoon conferences, fellows present critical care topics and relevant journal articles to the anesthesiology critical care faculty, fellows and OSP residents. Fellows also participate in multiple half-day critical care simulation sessions in our state-of-the-art simulation center.

Point of Care Ultrasound Experience

Our ultrasound curriculum is continuous throughout the fellowship, in order to provide ongoing learning in point of care ultrasound. Near the beginning of the academic year is the annual transthoracic echocardiography "boot camp" with both didactic and hands-on ultrasound learning. Our faculty are proficient in bedside transthoracic echocardiography and ultrasound in the ICU and this is an integral part of our ICU rotations. Fellows perform numerous scans during their training, including focused TTE, lung and pleural ultrasound, abdominal ultrasound, and vascular scans. In the cardiac ICU there is a weekly imaging review conference with our cardiologists, allowing opportunity for additional learning in TTE image acquisition and interpretation.

Benefits of the OSP

The Oregon Scholars Program is an innovative and exciting way for an 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-equipped to provide post-operative critical care. Also, familiarity with the challenges of ICU management in 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 complement 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 residents are well prepared prior to starting advanced critical care rotations. 

OSP residents are paired with faculty advisors from within the critical care division. This consistent mentorship throughout the program helps to integrate the junior residents into the critical care division and gives scholars an invaluable source of career advice and planning.

This thorough, integrated training has made our graduates highly competitive when applying for jobs or additional fellowships. Previous graduates have been very successful in obtaining positions in anesthesiology and critical care medicine at academic and private hospitals across the country. Others have gone on to pursue further fellowship training at prestigious programs.

Living and Training in Portland

OHSU is fortunate to be located in Portland, Oregon, which combines a vibrant city with natural beauty and proximity to outdoor adventures of all varieties. Portland is the largest metropolitan area in Oregon and has the variety of a major city with the friendly feel of a smaller town. The restaurant, microbrewery, winery, and coffee scenes are all highly acclaimed and constantly evolving. There are endless options, from food carts to James Beard award winning chefs.  Farmer's markets, food carts, and community gardens are scattered across the city. Trails and parks are found throughout and cycling, rain or shine, is a major mode of transportation. Additionally, the beautiful Oregon coast, ski slopes, wine country, and Columbia River Gorge are only a short drive away. 

Thank you for your interest in our critical care program. I look forward to hearing from you with any questions.

Sincerely,

Joanna Olsen, MD, PhD