Fellowship Program

The GW hospital is a level 1 trauma center in the heart of Washington DC. The center of trauma and critical care consist of 60-bed mixed Med-Surg ICU which includes the care of patients following major trauma, cardiothoracic surgery, neurosurgery and of all the medical and surgical subspecialties managed by the ICU team.

The critical care fellow, regardless of the program pathway, is involved in the care of all of these patients, and through their training will develop expertise in the management of critically ill patients across these disciplines. The diversified faculty composed of faculty based in Internal Medicine, Surgery, Anesthesiology, Emergency Medicine and Pulmonology as well as the strong relationships among subspecialties at GW further creates an environment of collegiality and scholarship that promotes the growth of leadership during the fellowship training.

This fellowship is known for the heavy clinical exposure to such a large and varied patient population requiring strong organizational and prioritization skills along with considerable learning capacity, with graduates being rewarded with a comprehensive training afforded by a breadth of clinical experience that is nearly unparalleled compared to other critical care programs in the United States.

 

Educational Goals and objectives

The goals of the George Washington University Critical Care fellowship program are to provide fellows with the knowledge base and clinical experience to successfully evaluate and treat medical and surgical conditions that require admission to the critical care unit. Our goal is to provide the trainees with the guidance and education needed to develop as the future leaders at the field of critical care, as they develop the skills and expertise needed to provide evidence-based medicine through professional and compassionate care. Commonly encountered conditions include sepsis, acute and chronic respiratory failure, acute renal failure, hemodynamic instability, overdoses and poisonings, acute neurologic insults, electrolyte and endocrine emergencies, coagulation disorders, post-operative and post major trauma complications.

 

As a mixed medical/surgical unit, the ICU fellow will also develop expertise in the management of patients with trauma, neurosurgical emergencies, cardiac, and critical obstetric and gynecologic disorders. Both the faculty and the sponsoring institution are fully committed to provide the educational program, resources, and facilities to meet these goals.

 

 

The fellowship in a nutshell

The program at the GW University Hospital aims to have the fellows experience the multidisciplinary management of critically ill patients with diverse patient population and pathology, while getting the chance to experience different management options with the diverse critical care faculty that are attending the units.  

Fellows will get to develop an interest and a career path supported by one to one mentorship during their training period. The fellowship will support the growth of the trainees and provide them the exposure required to lead the field in the future.  

The program would provide a rich environment to develop the trainees, while providing heavy training in:

 

  • Hemodynamic support, non-invasive and invasive monitoring
  • Advanced ventilatory management
  • Bedside point of care ultrasonography and critical care echocardiography  
  • Neurocritical care with dedicated neurology / neurosurgery support
  • Emergency neurological life support
  • Interest-specific elective training (airway management in the OR, nutrition in critical care, palliative care and others)
  • Research support and guidance

Applicants who completed training in Anesthesiology, Surgical and Internal Medicine Sub-Specialty graduates must complete a 12-month critical care fellowship. For those applicants who completed a core internal medicine or emergency medicine program, the fellowship training is for 24 months. At least 75% of training in these programs will be spent in the care of critically ill patients in the ICU. The remainder of the training will be in educational activities or performing research relevant to critical care.

 

Critical Care Support Services

  • Multidisciplinary staff support, from critical care nurses, techs, respiratory therapists, physical therapists, nutritionists and pharmacists  
  • Advanced interventional radiology support to help with diagnostic and therapeutic interventions needed for the critically ill patients, as in:  
      • Emergent and elective IR procedural support
      • Thrombectomy for pulmonary emboli
      • Embolization for active bleeding
      • Neuro-interventional support for large-vessel occlusion (LVO)
  • Neurology, neuro-interventional and neurosurgery support
  • Pulmonary hypertension specialists, cardiology and cardiac surgery support and co-management
  • Multidisciplinary ECMO team and left ventricular assist devices (LVAD) services
  • Surgical and medical subspecialty consultation services

 

 

 

Teaching and Educational Activities

 

Teaching Rounds:

As a multi-disciplinary unit, the fellow develops clinical experience in the management of patients with medical and surgical emergencies, along with trauma, neurosurgical and cardiothoracic emergencies.

The ICU team consist of one critical attending, one fellow, multiple senior and junior residents and medical students. The residents and interns are from different specialties including surgery, internal medicine, anesthesia, ob-gyn, and emergency medicine. The multi-disciplinary rounds also include nursing staff, pharmacy, nutrition services, physical therapy and case management.

The housestaff present the history and physical findings to the fellow and the attending for each patient on morning rounds and then an evidence-based discussion of the case ensues, focusing on the physical and hemodynamic findings, differential diagnoses and management plan. In addition to clinical bedside review, the team reviews the radiologic images for each patient. Cases provide a stimulus for discussion on topics including hemodynamic devices, ventilator modes and management, and review of evidenced based data.

 

Clinical Experience:

  • Teaching rounds
  • Residents supervision and teaching
  • Performing or supervising bedside procedures
  • ICU consultation services
  • Leading the emergency response team in the hospital
  • Triaging of critically ill patients
  • Communicating management plans with specialists involved
  • Conducting family and patient discussions / palliative care

 

Departmental Conferences and Lectures

  • Core Lecture Series: Weekly one hour lecture given by a critical care attending on a topic from the curriculum. Fellows, residents, and medical students attend.
  • Fellow Core Lecture Series: Twice weekly, a fellow gives a lecture to housestaff and attendings covering a basic topic from the critical care curriculum. The fellows play an active role in planning of these conferences.
  • Fellow lectures: Advanced monthly meeting / conference between the faculty and the fellows discussing high-yield topics and advanced critical care evidence-based interventions.
  • Morbidity and Mortality Conference: Each fellow will present a case at the monthly conference. The fellow will complete a self-analysis form for each case, in attempts to improve patient safety, patient care, and education. The fellow will perform a targeted literature review and present the data with respect to each case. The Morbidity and Mortality Conference will serve as stimulus for a quality improvement project.
  • Journal Club: Occurs monthly. Two articles from topics in current journals are presented by the fellow and discussed. Specifically, whether practice patterns should change based on the data review. A review of all abstracts from Critical Care Medicine is also reviewed.
  • Research meetings: Conducted monthly with the aim of guiding interested fellows the process of conducting a quality improvement or a research project.
  • Department Grand Rounds: Anesthesia, Surgery, and Medicine departments each have weekly grand rounds. Fellows and faculty attend to one of the GRs when critical care topics are discussed.

 

 

APPLICATION FORMS:

Anesthesia Critical Care Fellowship we participate in the SF Match Program www.sfmatch.org

After Match Application Form Link

Surgical Critical Care Fellowship: Application Form
-For Internal Medicine Critical Care Fellowship: Applications are submitted via the ERAS system- http://www.aamc.org/audienceeras.htm.

Medicine Critical Care Fellowship
Danielle Davison,MD
900 23rd St NW
Dept Anesthesiology, Room G2092
Washington, DC 20037
202-715-4089
ddavison@mfa.gwu.edu

 

Anesthesiology Critical Care Fellowship
Jacqueline Honig
900 23rd St NW
Dept Anesthesiology, Room G2092
Washington, DC 20037
202-715-4750
jhonig@mfa.gwu.edu

 

Fellowship Coordinator
Inga Ricks
Residency Coordinator
Office of Graduate Medical Education
900 23rd Street, NW, Suite 6120
Washington, DC 20037
202-994-7903
ILR1@gwu.edu