• Patient care: The compassionate, appropriate and effective treatment of health problems and the promotion of health
• Medical knowledge: Regarding established and evolving biomedical, clinical and cognitive sciences and the application of this knowledge to patient care
• Practice based learning and improvement (PBL): Involves investigation and evaluation of patient care, appraisal and assimilation of scientific evidence and improvements in patient care
• Interpersonal and communication skills: Result in effective communication information exchange and teaming with patients, their families and other health professionals
• Professionalism: Manifested through commitment to professional responsibilities, adhering to ethical principles and sensitivity to diverse patient populations
• Systems based practice (SBP): Manifested by actions demonstrating awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal care

The fellows will achieve the following general goals during their one-year residency:

• Successfully supervise daily activities of the junior members of the team
• Develop and implement daily therapeutic plans for the critical care management of patients under their care in close collaboration with faculty and primary surgical services
• Successfully design and implement independent clinical research projects or protocols under supervision and direction of the faculty
• Become proficient at teaching residents and fourth year medical students during daily rounds in the surgical critical care unit
• Maintain organization and administration of the critical care teaching conferences 
• Successfully coordinate small group discussions during the third year medical student surgical clerkship dealing with perioperative management, cardiovascular physiology, shock and other areas related to critical care
• Provide a high level of professionalism, interpersonal communication skills, ethical behavior and sensitivity to a diverse critically ill patient population and their families

In the ICUs, our fellows organize teaching/work rounds, formulate care plans, and facilitate communication between the ICU team and surgical services, consultative services, and family members. Our fellows serve as instructors for residents, medical students, nurse practitioners, and nursing staff. This includes formal CME-approved presentations, simulation sessions, and educational conferences throughout the year. Fellows also serve as instructors for Fundamentals of Critical Care Support (FCCS) and our nationally-recognized Critical Care Skills Week which exposes junior medical students to topics in anesthesiology and critical care. All fellows will also have an administrative responsibility within the fellowship (e.g., scheduling, journal club, morbidity and mortality).

The teaching curriculum includes daily didactic sessions that consist of lectures, research conferences and studios, quality improvement training, echo lecture and case review, journal clubs, mortality and morbidity conferences, board preparation, and many others. Fellows will participate in ‘boot camp’ sessions for topics such as critical care ultrasound, ECMO, and ICU procedures. In addition, all fellows will gain ATLS training if needed. Fellows participate in a defined echocardiography curriculum for diagnosis and guidance of therapy in critically ill patients and will gain proficiency in applications of ultrasound to include but not limited to the FATE, FAST, VTE assessment, lung and pleural examinations. Fellows also participate in monthly simulation training at Vanderbilt’s cutting-edge Center for Experiential Learning and Assessment (CELA).

The fellows will acquire advanced critical care knowledge and skills during their training, including:

• Cardiorespiratory resuscitation: Physiology, pathophysiology, diagnosis and therapy of disorders of the cardiovascular, respiratory, gastrointestinal, genitourinary, neurologic, endocrine, musculoskeletal and immune systems as well as infectious diseases
• Metabolic, nutritional and endocrine effects of critical illness
• Hematologic and coagulation disorders
• Critical obstetric and gynecologic disorders
• Trauma, thermal, electrical and radiation injuries
• Inhalation and immersion injuries
• Monitoring and medical instrumentation
• Critical pediatric surgical conditions
• Pharmacokinetics and dynamics of drug metabolism and excretion in critical illness
• Ethical and legal aspects of surgical critical care
• Principles and techniques of administration and management
• Biostatistics and experimental design

Core rotations for the fellowship include the CVICU, SICU, NCU, Trauma ICU, Burn ICU, VA-SICU, and ECHO/Ultrasound rotation with additional elective months. The fellowship program offers a diverse array of electives such as intraoperative TEE, MICU, PICU, palliative care, medical subspecialties (e.g., nephrology, infectious disease, and cardiology), nutrition, and the Medical Examiner's Office. Fellows who have academic interests are strongly encouraged to use elective time to develop and pursue clinical or basic science investigations and are expected to present their work at national conferences. Additionally, the Vanderbilt International Anesthesiology (VIA) program provides anesthetic and critical care services to poorly-served countries around the world, including Central America (Guatemala), East Africa (Kenya and Somalia), South Africa (Botswana), and West Africa (Ghana, Nigeria). Fellows may take one elective month to participate in VIA which presents opportunity for trainees to experience the challenges and rewards of practicing and educating in the developing world.

The fellows will acquire and demonstrate competence in the following specific critical care skills during training, including:

• Respiratory: Airway management, including endoscopy and management of respiratory systems
• Circulatory: Invasive and noninvasive monitoring techniques, including transesophageal and precordial cardiac ultrasound and application of transvenous pacemakers; computations of cardiac output, and of systemic and pulmonary vascular resistance; monitoring electrocardiograms and management of cardiac assist devices
• Neurological: Perform complete neurological examinations; use intracranial pressure monitoring techniques of the electroencephalogram to evaluate cerebral function; application of hypothermia in the management of cerebral trauma
• Renal: Evaluation of renal function; periotoneal dialysis and hemofiltration; knowledge of the indications and complications of hemodialysis
• Gastrointestinal: Utilization of gastrointestinal intubation and endoscopic techniques in the management of the critically ill patient; application of enteral feedings; management of stomas, fistulas and percutaneous catheter devices
• Hematologic: Application of autotransfusion; assessment of coagulation status; appropriate use of component therapy
• Infectious disease: Classifications of infections and application of isolation techniques; pharmacokinetics, drug interactions and management of antiobiotic therapy during organ failure; nosocomial infections; indications for application of hyperbaric oxygen therapy
• Nutritional: Application of parenteral and enteral nutrition; monitoring and assessing metabolism and nutrition
• Monitoring/bioengineering: Use and calibration of transducers, amplifiers and recorders
• Miscellaneous: Use of special beds for specific injuries, employment of pneumatic antishock garments, traction and fixation devices
• Conclusively demonstrate his or her ability to manage critically ill patients on their own in a safe, effective, collaborative manner

 All fellows will be required to complete collaborative institutional (CITI) review board training in the first 90 days of the fellowship.

• Purines and pyrimadines (under the leadership of Fievos L. Christofi, PhD)
• Cardiovascular anesthesiology (Mark A. Gerhardt, MD, PhD)
• Glucose control and monitoring, and its relation to wound healing; topics in infection control epidemiology (Thomas J. Papadimos, MD, MPH)
• Neuroscience monitoring and outcomes