Fellowship in Critical Care Anesthesia

Clinical ICU Training at Thornton ICU & Sulpizio CVC ICU

• Thornton ICU - 12 Bed Med-Surg ICU
• Sulpizio CVC - 12 Bed Med-Surg ICU

Options for Electives at Hillcrest Units

• SICU (Hillcrest) – 20 Bed Surgical /Trauma
• BICU (Hillcrest) – 8 Bed Burn

Future Expansion may include: VA-ICU and Pediatric ICU Rotation at Rady Children’s Hospital

Critical Care Faculty

Anushrivan Minokadeh, MD – Division Chief
Medical School: LSU,
Anesthesiology Residency: SUNY Downstate Hospital
CCM Fellowship: Johns Hopkins
Interests: Neurocritical Care, Liver Transplantation, Resuscitation Science, Quality and Performance Improvement

E. Orestes O'Brien, MD – Clinical Chief
Medical School: Harvard
Anesthesiology Residency: UCSF
CCM Fellowship: MGH
Interests: Transthoracic Echocardiography and the Sympathetic Nervous System in Critical Illness

Kimberly Robbins, MD – Fellowship Director
Medical School: University of Virgina
Anesthesiology Residency: UCSD
CCM Fellowship: UCSD
Interests: Obstetric Critical Care, Echocardiography, Education

Beverly Newhouse, MD – Education Director
Medical School: University of North Carolina
Anesthesiology Residency: UCSD
CCM Fellowship: MGH
Interests: Medical Education, Mechanical Ventilation & Weaning, Resuscitation Physiology

Erik Kistler, MD, PhD – Director of Research
Medical School: George Washington University
Anesthesiology Residency: UCSD
CCM Fellowship: MGH
Interests: Sepsis and Shock (Mechanisms, Diagnosis and Treatment)

Brian Lemkuil, MD
Medical School: Loma Linda
Anesthesiology Residency: UCSD
CCM Fellowship: UCSD/Cambridge
Interests: Cerebral Blood Flow, Subarachnoid Hemorrhage, Cerebral Vasospasm

Zeb McMillan, MD – Fellowship Journal Club Director
Medical School: University of Iowa
Anesthesiology Residency: Advocate Illinois Masonic Medical Center
CCM Fellowship: UCSF
Interests: Venous Blood Gas Analysis, Ventilator Synchrony Pain and Sedation in ICU, RBC transfusion

Angela Meier, MD, PhD
Medical School: Ludwig Maximlans University (Munich)
Anesthesiology Residency: MGH
CCM Fellowship: MGH
Interests: Sepsis, Trauma, Immunologic Impact of Anesthesia

Albert Nguyen, MD
Medical School: University of Colorado
Anesthesiology Residency: UT Southwestern
CCM Fellowship: UCSD
Interests: Coagulopathy and Coagulation Monitoring

Ulrich Schmidt, MD, PhD, MBA
Medical School: University of Munich
Anesthesiology Residency: MGH
CCM Fellowship: MGH
Interests: Care of the Critically ill patient in OR and in the ICU, Optimization of high risk interventions in the ICU

Christopher "Kit" Tainter, MD, RDMS - Director, Anesthesia Critical Care Ultrasound
Medical School: University of Washington
Emergency Medical Residency: Mount Sinai NY
CCM Fellowship: MGH
Interests: Point of Care Ultrasound, Resuscitation, Cardiac Arrest, Education

Kimberly Pollock, MD
Medical School: Medical College of Wisconsin
Anesthesia Residency: UCSD
CCM Fellowship: UCSD
Interests: TBD

Educational Overview

Core and Elective Rotations

• Each fellow will spend 9-11 months of clinical training inThornton ICU (T-ICU) and Sulpizio Cardiovascular Center (S-CVC) ICU. The bulk of primary patient management will occur in the T-ICU, most of the clinical experience in the S-CVC ICU will be consultative, but for certain surgeons, the Fellow will have primary management responsibilities as well.
• In addition, the Fellow can opt for 1-2 months of elective time either on corollary services with relevance to critical care (e.g. Infectious Disease, Cardiology Service, TEE Service), or they can spend time in the UCSD Burn Unit at Hillcrest or the UCSD Trauma/SICU also at Hillcrest.

Expectations & Goals

• The primary goal of the core fellowship training (occurring at T-ICU/S-CVC ICU) is to provide the
  fellow with clinical experience in the management of critically ill surgical &(some) medical patients.
• The Fellow will also develop expertise in coordinating a multidisciplinary team, and in all of the common procedures used in CCM.
• Training in TEE, TTE, & Bronchoscopy will be specifically emphasized & provided to all fellows.

TEE and TTE Training

(All Fellows will become competent in both modalities)

Echo Training Includes:

• Principles of 2D and Doppler echo, workings of the Echo machine & physics governing use of various probes.
• Expertise in obtaining 20 view TEE exam & abbreviated exam for HD unstable patients.
• Competence in Echo-assisted invasive line placement.
• Imaging of all cardiac & vascular structures. Recognition of common pathological echo findings (e.g. LV function, volume, RWMA, tamponade, Mitral, Aortic & tricuspid valve evaluation, etc.)
• Proficiency in Doppler measurements & calculations.
• TEE & TTE Simulator available, and incorporated in curriculum.
• At Fellowship completion, each Fellow should be eligible to attain the American Board of Echocardiography’s certification.

Fiberoptic Bronchoscopy (FOB) Training

• FOB Training and experience is one of the Core CCM Procedures that will be mastered by ACCM Fellows.
• All Faculty are proficient in FOB use and teaching.
• In addition, Dr. Jonathan Benumof, “originator of the ASA Difficult Airway Algorithm”, will personally teach FOB techniques in his Difficult Airway Lab.
• An Airway Simulator is available.
• All Fellows will become expert bronchoscopists.

Research Opportunities

• Abundant research opportunities are available.
• All Fellows will be expected to graduate with one completed research project, including the production of a manuscript suitable for publication.
• Several ongoing projects are available to Fellows, or they can choose topics of their own.
• A list of current research projects will be provided during interview.
• UC San Diego belongs to the “UC Goal Directed Therapy Consortium”. As a member of this research group, we are actively involved in trials focused on optimizing the endpoints of resuscitation.
• CCM Faculty will closely assist the fellows in all aspects of research.

Eligibility Criteria 

Candidates for admission to University of California, San Diego Anesthesia Critical Care Fellowship must have the following criteria:

• Completion of an ACGME-accredited core Anesthesiology Residency Program. At this time, we do not offer a two year program acceptable for board eligibility for Emergency Medicine applicants.
• Board certification (or eligibility) in Anesthesiology by the ABA (or equivalent if non-American trained)
• Possess (or be eligible for) a California medical license (must have current license in State of Residence at time of application).
• Be intellectually curious, and of strong personal & moral character.
• Demonstrate interest in pursuing a career in critical care medicine.

Appointment is contingent upon:

• Satisfactory criminal background check
• Full compliance with the licensure regulations of the Medical Board of California and Federal Immigration Laws.

Application Process

The UCSD Anesthesiology Critical Care Medicine Fellowship Program participates in the SF Match system and we are now utilizing the Central Application Service. Information about the SF Match system application process can be found on the San Francisco Matching Progam. We are now accepting applications for 2017 Critical Care Anesthesiology Fellowship Match for 2018 positions.

Once an applicant has completed their application and submitted the required three letters of reference, SF Match will distrubute the applications to the programs on the applicant's distribution list.

Applicants are required to have the following documents:

1. Complete and submit CAS application form (online)
2. Three letters of reference: One letter must be from a training Program Director or Chair and the others from objective physicians (with one preferably from an intensivist) who have direct personal knowledge of your skills and ethics.