Critical Care Medicine - Fellowship Program

The Warren Alpert Medical School of Brown University and its affiliated teaching hospitals offer a 1-2 year training program in Critical Care Medicine.

One to two fellowship positions are offered each year for training in Critical Care Medicine. Additional years for research training are encouraged. Applications for the fellowship are accepted through ERAS (the Electronic Residency Application Services).

Eligible candidates for the 2 year fellowships include graduates of ACGME-accredited residencies in Internal Medicine or Emergency Medicine. Eligible candidates for the 1 year fellowship include previous graduates of an approved ACGME-accredited subspecialty fellowship of Internal Medicine (most often Pulmonary Medicine).

The purpose of the fellowship is to prepare board eligible or certified internists for a career in clinical or academic Critical Care Medicine. In all aspects of the educational program, the Fellow is encouraged to develop an attitude of scholarship and the intellectual curiosity to remain in the informational forefront of the discipline throughout his or her professional lifetime.

The training program is specifically designed to:

  1. Provide the basic and clinical knowledge to effectively care for critically-ill patients
  2. Develop the ability to perform relevant invasive procedures
  3. Develop the skills and credentials necessary to pursue a career in academic Medicine
  4. Develop the skills needed to lead a critical care unit

Basic Information:

Sponsored by: Rhode Island Hospital and The Miriam Hospital (primary teaching site)

Program size: Year 1 and 2 = One open position per year.

NRMP: This program does not participate in the National Resident Matching Program or any other matching program.

ERAS: Applications are only accepted via ERAS. Earliest dates for applications are July, latest date is December. The interview process goes from September to January.

USMLE: Step 1 is required

ECFMG: Is required

Citizenship: US Citizen, US permanent resident and J-1 applicants are accepted

ACGME: http://www.acgme.org/acgmeweb/Portals/0/PFAssets/2013-PR-FAQ- PIF/142_critical_care_int_med_07132013.pdf

EM Applicants: Emergency medicine applicants require 6 months of pre-requisite residency training in internal medicine rotations. If an emergency medicine graduate enters a critical care medicine program with less than the prerequisite clinical education, he or she will need to complete the remaining months at the beginning of fellowship. These additional months will not add to the overall 24 month training time, but will reduce months otherwise available for research or electives.

Clinical Rotations

Overview

The primary clinical sites are the Miriam Hospital and Rhode Island Hospital Intensive Care Units. Additional required rotations are in the Rhode Island Hospital Trauma Intensive Care Unit and Neurosurgical Intensive Care Unit. Possible electives include rotations in the Respiratory Care Unit, Anesthesia, Toxicology and the Pediatric Intensive Care Unit at Hasbro Children's Hospital. The fellowship utilizes a "Night Float" ICU rotation at the RIH ICU.

A typical 2-year rotation schedule is shown below.

Year 1

Year 2

July

Elective

TMH ICU

August

TMH ICU

TMH ICU

Sept

6 INC

TICU

Oct

Res

Elective

Nov

NF/Res

NF/Res

Dec

TMH ICU

TMH ICU

Jan

NF/Res

NF/Res

Feb

Res

Res

March

RIH MICU

RIH MICU

April

TMH ICU

TMH ICU

May

RIH MICU

RIH MICU

June

Res

Res

TMH ICU
RIH MICU
NF = Night Float RIH MICU

Res = Research

TICU = Trauma Intensive Care Unit, RIH
6 INC = Neurosurgical ICU, RIH

Participating Hospitals

The Miriam Hospital is a 247-bed, acute care general hospital in Providence and is a major teaching site for the Alpert School of Medicine. The ICU is a 16-bed, combined medical/surgical/cardiac unit which provides a very broad educational experience with an emphasis on collaborative rounds with these varied services. In addition the medically-ill patients, cardiac patients in this unit provide extensive experience in cardiogenic shock, intra-aortic balloon pumps, hemodynamic monitoring and pacing. Extensive experience with critically-ill post-operative patients is also obtained here.

Rhode Island Hospital is a 721-bed tertiary care hospital with a broad spectrum of pulmonary and critical care diseases. It is the state's largest hospital and the third largest hospital in New England. The 18-bed Medical Intensive Care Unit at Rhode Island Hospital has a high turnover of acutely ill patients with multi-system failure and was recently recognized by the National Coalition on Healthcare as one of the ten best in the country. It serves as a referral center for many hospitals throughout southern New England and is now also an ECMO center. Experience with critically-ill obstetric patients is also obtained here.

Curriculum

Our goal is to provide an educational environment which fosters the acquisition of the necessary knowledge, skills, clinical judgment and professional attitude that is essential to the practice of Critical Care Medicine. As such, all conferences are shared between the 2 year critical care medicine program and the combined, 3-year pulmonary and critical care medicine program. The curriculum includes:

Clinical Rotations in the Critical Care Units: This training experience is in the ICUs at both Miriam and Rhode Island Hospitals. These units have a high turnover of acutely ill patients with multi-system failure. The care of these patients is under the direct supervision of a full-time pulmonary or critical care attending. When assigned to the unit, the critical fellow makes daily rounds with the attending for 3-4 hours per day and supervises a team of residents and medical students. Methods of weaning, ventilator management and hemodynamic monitoring are emphasized on daily teaching rounds.

Weekly Fellow's Conferences: These conferences occur twice per week at TMH and focus on literature review, case presentations and discussions. The program maintains a database of "key articles" that are discussed throughout the year in this format.

Pulmonary Grand Rounds: This weekly teaching conference is held on the Warren Alpert Medical School of Brown University campus with the entire faculty and with pulmonary and critical care specialists in the practicing community. This conference begins in September and is preceded during the summer by an introductory lecture series for the clinical fellows. The conference focuses on important topics in clinical medicine through a case presentation format. Annotated bibliographies are distributed to provide an updated reference base.

Combined Medical/Surgical/Trauma Teaching Rounds: This conference is held twice a month at Rhode Island Hospital. The management of a variety of diseases encountered in Medical, Surgical and Trauma ICUs is discussed.

Journal Club: Held monthly, this evidence-based medicine journal club is intended to teach fellows to evaluate critically the current literature in Pulmonary and Critical Care Medicine and assess the likelihood of it changing clinical practice.

Stipends and Benefits

Expected is that all first year fellows will enter the program at the PGY 4 level. Salaries for fellows are concomitant with their post graduate level. Funding arranged for fellows to attend educational conferences.

Application Information

Note: There are two positions available for 2020.

The Critical Care Medicine program accepts applications through the ERAS electronic application service. We will no longer be processing independent applications by mail through our office.

For additional information, please contact Elizabeth Correia, Program Coordinator, at ecorreia@lifespan.org or 401-793-4501.

Patient Services

Members of the Department of Medicine provide both Primary Care Clinical services and Subspecialty Clinical services. Locations include community-based private physician offices, Foundation-owned group practices and the hospitals listed below.

Rhode Island Hospital, a large academic medical center.

The Miriam Hospital, a community based teaching hospital.

Memorial Hospital of Rhode Island, a community based teaching hospital.

Women & Infants Hospital of RI, the 10th largest OB/GYN hospital in the U.S.

Providence VA Medical Center, serving a unique patient population & spectrum of illness.