The Anesthesia Critical Care Medicine (ACCM) fellowship at the University of Pennsylvania has been designed to prepare fellows for a career in Anesthesiology with an emphasis on Critical Care Medicine. The ever expanding role of Anesthesiologists in academic medicine, as well as the private sector, has opened a variety of interests within the broader field of Critical Care. We strongly encourage applications by candidates seeking dual certification in Critical Care and Cardiac Anesthesia.
The goal of the ACCM fellowship is to provide the candidate with a solid foundation in the management of critically ill adult surgical patients. To this end, fellows are required to satisfactorily complete the following core rotations:
3 months, Surgical ICU (SICU, Hospital of the University of Pennsylvania)
3 months, Trauma and Surgical ICU (TSICU, Presbyterian Hospital)
2 months, Heart and Vascular ICU (HVICU, Hospital of the University of Pennsylvania)
1 month Neurological ICU (NICU, Hospital of the University of Pennsylvania)
1 month, transthoracic echocardiography
The fellows in the SICU and TSICU manage trauma, general surgery, thoracic surgery, transplant surgery, urology, and ENT patients in a true multidisciplinary environment. The rotation in the HVICU provides clinical experience managing patients following complex cardiac procedures. In addition to patients undergoing standard valve and CABG surgery, fellows will learn to manage the perioperative care of patients undergoing lung transplant, heart transplant and complex mechanical circulatory support such as ECMO and VAD. Advanced didactics on the management of the neurologically impaired patient is obtained in the Neurological Intensive Care Unit, under the supervision of a mixed anesthesiologist / neurologist faculty. Formal ICU ultrasound teaching and didactics are provided through the echocardiography rotation. In addition, the fellow is exposed to a yearlong curriculum in bedside ultrasound that includes ACCM faculty run didactics, bedside teaching, and supervised image interpretation, with emphasis on transthoracic cardiac, lung, and abdominal ultrasound. Transesophageal training (TEE) is also available on an elective basis.
To accommodate fellows' individual interests, we offer a variety of subspecialty electives that embrace the enormity of resources available within our health care system. We encourage fellows to think "outside-the-box" and work with them to design novel elective plans that will allow for a more unique and personalized training. Some examples of popular electives include:
- Emergency/Trauma ultrasonography
- Transesophageal echocardiography
- Medical critical care
- Critical care radiology and neuroradiology
- Infectious disease for the ICU
- Nephrology and renal replacement therapy in the ICU
- Palliative care and ICU hospice
- Basic, Clinical, Translational Research
- International outreach medicine
- Globalized ICU development
The ACCM fellowship strongly encourages additional rotations in the Heart and Vascular ICU at Presbyterian hospital, where the fellows gain exposure to Penn's lung rescue program for severe pulmonary compromise requiring extracorporeal support.
Cardiac Critical Care Focus Pathway
In addition to the core curriculum, Penn's ACCM fellowship has designed an AGCME track dedicated to prepare clinicians for a career in Cardiac and Vascular Critical Care Medicine. With the ever increasing number, acuity, and comorbidities of patients undergoing high-risk cardiovascular surgery, there is a need to accommodate the demand for highly trained intensivists in this field of Critical Care. The additional fellowship track with a special focus on Cardiothoracic Critical Care Medicine is accessible to physicians with primary specialties of Anesthesia, Surgery, and Cardiothoracic Surgery. Clinical time in the ICU includes a minimum of 8 months in the HVICU and additional rotations through the Trauma, General Surgery ICU and electives.
Finally, fellows are encouraged to participate in some scholarly project during their year of critical care. This has been intentionally defined vaguely in order to allow trainees the ability to explore various opportunities. Some recent scholarly projects include:
- Co-authoring a chapter on a Critical Care topic
- Design of an ICU study with proposal submission
- Preparation and presentation of abstracted study at a national meeting
- Participation in formal translational research with designated mentor
Quality Improvement Activities
The ACCM fellowship expects fellows to be engaged with quality improvement (QI) and performance improvement (PI) priorities of our health system. Fellows will be involved with initiatives across the spectrum of patient safety, health care quality, and care transition. This will occur through participation in ICU leadership meeting, quality improvement committees, participation in specific QI projects, and completion of QI/PI didactic activities provided by our office of Graduate Medical Education (http://www.uphs.upenn.edu/gme/), among others.
We aim to develop future leaders within our field. To this end, emphasis throughout the year is dedicated to developing leadership skills with the ultimate goal of training competent critical care physicians who are capable of leading a diverse team of individuals with a variety of training and backgrounds. Throughout your year of fellowship, the fellow will develop the necessary skills to become not only an outstanding intensivist, but a team leader.
In short, the University of Pennsylvania is a diverse, multifaceted institution with virtually unlimited resources for the motivated applicant.
- Maurizio Cereda, M.D.
Program Director, Critical Care Medicine Fellowship
Co director, Surgical ICU
Department of Anesthesiology and Critical Care
Perelman School of Medicine
|Name||Clinical Areas*||Research, Other Interests|
|Maurizio Cereda||General Surgical Critical Care, Trauma Critical Care||Acute respiratory distress syndrome, lung imaging, mechanical ventilation|
|Scott Falk||General Surgical Critical Care, Cardiovascular critical care||Patient safety and quality improvement|
|Emily Gordon||General Surgical Critical Care, Cardiovascular critical care||Medical education|
|Jacob Gutsche||General Surgical Critical Care, Cardiovascular critical care||Lung rescue (ECMO)|
|C. William Hanson||General Surgical Critical Care||Medical informatics|
|Jiri Horak||General Surgical Critical Care, Cardiovascular critical care||Echocardiography guided resuscitation, right ventricular failure|
|Hanjo Ko||Cardiac Surgical Critical Care, Cardiac Anesthesia||Transthoracic Echocardiogram, Transesophageal Echocardiogram, Lung Transplant|
|W. Andrew Kofke||Neurocritical care||Neuromonitoring, functional genomics|
|Elizabeth Mahanna||Neurocritical care, General Surgical Critical care||Neurocritical care, postoperative delirium|
|Meghan Lane-Fall||General Surgical Critical Care, Trauma Critical Care||Handoffs, teamwork, communication, ICU staffing, quality improvement research, implementation science, mixed methods research|
|Krzysztof Laudanski||General Surgical Critical Care, Trauma Critical Care||Sepsis, SIRS, immunology, long-term outcome after critical care events|
|Howard Nearman||General Surgical Critical Care||Fluid resuscitation, sepsis, oxygen delivery physiology|
|Jesse Raiten||General Surgical Critical Care, Cardiovascular critical care||Global health, Patient safety and quality improvement|
|Amy Reed||General Surgical Critical Care, Trauma Critical Care||Sepsis, Immunology of critical illness, Pulmonary immunopathology|
|Kristen Rock||Cardiovascular critical care, Trauma Critical Care||Medical ethics and medical education|
|Hazel Werlhof||General Surgical Critical Care, Cardiovascular critical care||Ultrasound, global health|
As part of the educational mission, the fellowship provides lecture series, journal clubs, and highlights educational case presentations throughout the course of the year. In addition, fellows are required to participate in a summer course directed at establishing a firm foundation in the fundamentals of critical care medicine. The schedule and lectures are provided below:
The ACCM fellowship at the University of Pennsylvania participates in the SF Match www.sfmatch.org. Please make sure you have registered with SF Match and note the application deadlines listed on their website.
Required documentation to complete your application includes:
- Registration with SF Match
- Completed Fellowship Application Form
- Personal statement
- Three (3) letters of recommendation
- Updated CV
- Passport sized photo
- USMLE Scores (copy)
- Copy of Dean's letter and medical school transcript (copy)
- In-Training Examination scores (copy)
Note: CCM and CT dual fellowship candidates when registering for the SF Match. Please register for ONLY ONE, CT or CCM (which ever you choose to do first). Please indicate on your application that you are interested in the dual fellowship.
Please send the application materials noted above in italics (in one PDF) and direct questions to the following email address: firstname.lastname@example.org
Fellowship Program Coordinator
Department of Anesthesiology and Critical Care
University of Pennsylvania Health System
3400 Spruce Street, 6th Floor Dulles
Philadelphia, PA 19104