Critical Care Fellowship

About the program

Fellows will gain hands-on experience across various intensive care units at Baylor University Medical Center and our adjoining Baylor Scott & White Heart and Vascular Hospital, including surgical/trauma, medical cardiac, cardiovascular, neuro, BMT, and medical ICUs. Additionally, fellows will work with mechanical circulatory support and our Platinum Designated ECMO program. BUMC is equipped with 124 critical care beds in total.

To ensure focused learning, each ICU unit features dedicated teaching hallways, limiting patient volume and allowing for a careful selection of complex cases. Faculty lead daily multi-disciplinary teaching rounds, providing bedside instruction, discussing pathophysiology, and incorporating current evidence into clinical decisions. Each team is limited to 15 patients, fostering a high-quality, individualized learning experience.

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 fellowship rotation schedule for the year offers a comprehensive and immersive ICU experience, with all rotations taking place on-site. We offer two distinct training tracks: the Cardiology Fellowship Track and the Nephrology and Infectious Diseases Fellowship Track. Rotations are tailored to align with each fellow’s subspecialty background, ensuring a personalized and relevant clinical experience.

Fellows are actively involved in patient care throughout the day, typically from 7 a.m. to 6 p.m. Responsibilities include evaluating new admissions and consults, triaging patients, presenting cases to attending physicians, and documenting consultations. Fellows also see established patients prior to daily bedside rounds.

Training is collaborative, with fellows working alongside specially trained nurses and technicians experienced in critical care instrumentation, respiratory therapy, and laboratory medicine. There is no overnight call.

Conferences

within our institution

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
• Advanced Heart Failure and Transplant 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).