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 The Program Director of the Anesthesiology Critical Care Medicine (ACCM) Fellowship is Dr. Robert N. Sladen, who is Medical Director of the Cardiothoracic and Surgical Intensive Care Units and Medical Director of Respiratory Therapy at Columbia University Medical Center. Dr. Sladen is a Fellow of the American College of Critical Care Medicine (FCCM) and a Past-President of the American Society of Critical Care Anesthesiologists (ASSCA). The Critical Care Division consists of a group of dedicated critical care anesthesiology faculty, including Dr. Sladen (Chief), and Drs. Mary Ellen Bass, Tricia Brentjens, Sumeet Goswami, Desmond Jordan, Joseph Meltzer, Vivek Moitra, Oliver Panzer, Joseph Rumley, Peter Salgo, Gebhard Wagener, Staffan Wahlander and Hannah Wunsch.
Each year, up to seven positions are available in this 12-month ACGME-accredited program. It is designed to take the Fellows through increasing levels of experience and responsibility and prepare them for Board Certification in Anesthesiology Critical Care Medicine (ACCM). The Fellows supervise and teach anesthesiology and surgery junior house staff and medical students under the direction and guidance of the ICU Faculty. The Fellows rotation is organized into 13 four-week blocks. About 50% of the year is spent as a key member of the ICU team on the Cardiothoracic Intensive Care Unit (CTICU, 21 beds) and Surgical Intensive Care Unit (SICU, 16 beds). Combined, the two units average about 2,400 admissions per year. Together they provide postoperative care for patients undergoing transplantation (heart, lung, liver, pancreas), ventricular assist device insertion, CABG and valvular surgery, major thoracic surgery, major vascular surgery and a wide variety of general and subspecialty surgical procedures. The ICU Fellows have an office with computer support and sleeping facilities directly adjacent to the CTICU and SICU. About 25% of the year is spent providing consultation outside the ICU, and about 25% of the year on elective rotations tailored to the individual Fellow’s interests. Choices for electives include Medical ICU, Coronary Care Unit, Neuroscience ICU, Pediatric ICU and selected outside rotations. In addition there is instruction and hands-on experience in transesophageal and transthoracic echocardiography throughout the year. Our goal is to give our Fellows exposure to a wide variety of ICU problems and approaches. Each Fellow takes ICU Call one night in six or seven in the two "home units" (CTICU and SICU) throughout the year, with day off after call. In addition there is a night float week (nights only, Monday through Friday) every seventh week. As the year progresses the ICU Fellow takes increasing responsibility for the conduct of rounds and decision-making, while the ICU Attending remains available for backup and support as appropriate.
Twice weekly the ICU Fellow leads multidisciplinary bedside rounds attended by the ICU Nurse Manager, Social Worker, Respiratory Therapist, Physical Therapist and representative of Ethics Committee. The goal is to formulate joint strategies for family support and discharge planning of long-term ICU patients. Every ICU Fellow is a full member of the CT-SICU Multidisciplinary Quality Improvement Committee, which meets monthly and includes the ICU Faculty, Nurse Managers and senior nursing staff, and representatives from Respiratory Therapy, Pharmacy, Social Services, Nutritional Support, Laboratory and Hospital Quality Assurance. The Fellows, together with the Faculty, give lectures at the ICU Teaching Conference for medical students, residents, physician assistants and nurse practitioners, as well as their own Fellowship seminars (see below). They are responsible for coordinating our monthly Morbidity and Mortality Rounds. During the year Fellows, together with an ICU Faculty mentor, provide presentations at Department of Anesthesiology Grand Rounds and at Critical Care Grand Rounds. Our Fellows are encouraged to attend major critical care meetings such as the American Society of Critical Care Anesthesiologists (ASSCA) or the Society of Critical Care Medicine (SCCM). The Department of Anesthesiology provides $1,600 each year toward academic support and activities for each Fellow.
Fellows are encouraged to participate in ongoing research projects and are given all available assistance in setting up their own research projects. Funding is obtained through grants approved by the Department of Anesthesiology and outside funding agencies. Through the Columbia University Office of Clinical Trials, Fellows obtain certification in Good Clinical Practice and attend an annual course at the Irving Center for Clinical Research on clinical research protocol design and statistics. Current areas of research interest include: 1. ICU Outcome Studies – Validation of Predictive Models 2. Sedative and analgesic regimens in the ICU 3. Renal protective strategies in the ICU ICU Research Meeting: 2:30 p.m. – 3:30 p.m., twice per month Venue: SICU Conference Room, This Meeting is organized by the ICU Clinical Research Coordinator, and is open to all ICU Fellows as well as Faculty and research coordinators. We review and discuss all ongoing and developing research projects in the Division. It is an opportunity for ICU Fellows to learn about projects that they may be interested in joining, or to present their own ideas. ICU Teaching Conference: Every Monday, Tuesday, Friday 1:30 p.m. – 2:30 p.m. Venue: SICU Conference Room, Milstein Hospital 4th Floor This Conference is organized and coordinated by Dr. Vivek Moitra. Three days a week a one-hour tutorial is presented to the ICU residents, medical students, physician assistants and nurse practitioners. It provides didactic coverage of the ICU Core Curriculum to supplement rounds and bedside teaching by the ICU Faculty. Lecturers include the ICU Faculty, Fellows, CUMC Faculty (e.g. pulmonologists, cardiologists, ID specialists, nephrologists etc.), and Visiting Professors. The Conference is also a venue for in-services on new devices, equipment and protocols. Critical Care Fellows’ Seminar & Journal Club: Every Wednesday 1:30 p.m. – 3:30 p.m. Venue: SICU Conference Room, Milstein Hospital 4th Floor Drs. Joseph Meltzer and two of the ICU Fellows coordinate this weekly Journal Club specifically for the Fellows and ICU Faculty. Discussion assignments are rotated among the ICU Fellows. The goal is to stimulate interactive discussion on a wide range of topics in critical care medicine. These include “classic” critical care papers, recent therapeutic advances, evidence based medicine, ethics, medico-legal issues, and other issues pertinent to organization and medical direction of an ICU. On the last Wednesday of each month we have a Multidisciplinary Critical Care Journal Club that is organized jointly by the Faculty and Fellows of the CTICU and SICU with those of the Medical ICU and Neurosciences ICU. Our Fellows alternate presentations of journal articles with the Pulmonary Fellows and Neurosciences ICU Fellows. Discussion is led by the joint ICU Faculty. ICU Morbidity and Mortality Conference: Second Friday of each month, 1:30 p.m. – 2:30 p.m. Venue: SICU Conference Room, Milstein Hospital 4th Floor The ICU Morbidity and Mortality Conference is coordinated by the ICU Fellows. Their responsibility is to report on all mortalities in CTICU and SICU during the preceding month, with comments and discussion by the ICU Faculty as appropriate. One or two cases representing sentinel events or major morbidity are selected by the Fellows for more detailed discussion. Critical Care Grand Rounds: Every Thursday 3:00 p.m. – 4:00 p.m., September through June. Venue: Room 5-411 Garden North, Milstein Hospital, 5th Floor Critical Care Grand Rounds is a conference open to all staff at Columbia University Medical Center with an interest in critical care medicine. The audience includes Faculty and House Staff, Nursing Staff, Therapists, Pharmacists and Medical Students. Lectures are presented by Faculty at Columbia University, and Visiting Professors who are experts in critical care and related fields. Our Fellows participate in giving ICU case presentations at Critical Care Grand Rounds at least twice each year. Multidisciplinary Critical Care Journal Club: Last Wednesday of each month 2:30 p.m. – 3:30 p.m. Venue: Cournand Conference Room, Presbyterian Hospital 9th Floor Multidisciplinary Critical Care Journal Club is organized jointly by the Faculty and Fellows of the CTICU and SICU with those of the Medical ICU and Neurosciences ICU. Our Fellows alternate presentations of journal articles with the Pulmonary Fellows and Neurosciences ICU Fellows. Discussion is led by the ICU Faculty. Robert Sladen, M.D., FCCM
Joseph Meltzer, M.D.
Mary Ellen Bass, M.D.
Vivek Moitra, M.D.
Joseph Rumley, M.D. Gebhard Wagener, M.D. Hannah Wunsch, M.D., M.Sc.
Adriana Rodriguez
Ms Anke Freude
For more detailed information on the Fellowship and to initiate the application process, please e-mail Ms. Freude at af2409@columbia.edu, or call her at 212-305-8633. Our fax number is 212-305-8287, and our mailing address is: Robert N. Sladen, M.D., FCCM
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