Cardiac Critical Care Fellowship

Procedures

The training program aims to educate fellows in enhancing their understanding of diverse critical care medicine topics, applying this knowledge directly to patient care at the bedside, assessing clinical outcomes to ensure effective critical care services, and mastering technical and procedural skills essential for practitioners of critical care medicine.

Fellows have access to advanced technology and services, including:

• Bronchoscopy suite, including appropriate space and staffing for pulmonary procedures applicable to critical care
• Computed tomography (CT) imaging, including CT angiography
• Coronary care unit
• Radiology services (bedside imaging services available to all patients in the critical care units)
• Respiratory care services
• Exposure to the advanced heart and lung diseases and post-op heart and lung transplant patients
• Inpatient work in the cardiothoracic intensive care unit, including
  • ECMO care
  • Central venous and arterial catheterization
  • Intubation
  • Chest tube placement
  • Pulmonary artery catheter insertion and monitoring
  • Percutaneous tracheostomy
  • Percutaneous endoscopic gastrostomy tube insertion
  • Fiber-optic bronchoscopy

We also utilize the Seeger Surgical Simulation Center, which is equipped with SimMan 3G technology as well as bronchoscopy.

Baylor University Medical Center is a quaternary referral center and performs high-volume heart transplants, high volume durable VAD implants and high volume ECMO including VV, VA and eCPR.

CY-23

• Heart Transplants - 63
• VAD Implants - 36
• ECMO - 162

Rotations

The rotation schedule for the year provides a comprehensive experience in the ICU. All rotations will take place on site or at our adjoining heart and vascular hospital. Fellows receive new admissions/consults, triage and evaluate patients, present to the attending physician and provide documentation of consultation, typically between 7 a.m. and 6 p.m. daily during rotations. They also are responsible for seeing established patients prior to the daily bedside rounds. Fellows work with specially trained nurses and technicians skilled in critical care instrumentation, respiratory function and laboratory medicine. There is no overnight call.

• Orientation Block – one month
• MICU/CICU/BMT - six months
• CVCC, MCS, ECMO – three months
• SICU/Trauma - one month
• Elective – one month

Conferences

Each conference will have at least one faculty member present to facilitate peer-to-faculty interaction. This approach enhances the educational experience, providing the fellow with the opportunity to engage in meaningful discussions, seek guidance, and benefit from the expertise of experienced faculty members. The program aims to create a dynamic and inclusive learning environment that accommodates the diverse needs and circumstances of the fellow. Fellows develop teaching skills necessary to educate patients, families, medical students and residents by attending conferences and faculty development seminars, completing online lessons and observing experienced attending physicians in a teaching environment. These conferences are also attended by our surgical critical care and pulmonary/critical care fellows.

Conferences include:

• Radiology Case Conference
• Internal Medicine Grand Rounds
• Critical Care Core Curriculum Conference, including M&M and Journal Clubs
• Critical Care Conference
• Airway Management Conference
• Pulmonary Thromboembolism Conference
• Pulmonary Vascular Disease Conference
• ECMO Conference

Research

Our fellows are required to participate in at least one research project during their time as fellows, with the goal of presenting and publishing their findings.

BUMC is a major center for clinical research. Clinical research opportunities are available in the inpatient settings and the Seeger Surgical Simulation Center. Clinical research requires successful completion of educational prerequisites from Baylor University Medical Center's institutional review board (IRB) and approval of the IRB.

Fellows can present at conferences such as CHEST, Society of Critical Care Medicine, and American Thoracic Society (ATS), as well as at transplant-related conferences such as the American Transplant Congress (ATC) and the International Society for Heart and Lung Transplantation (ISHLT).