Awesome anesthesia critical care programs

[jc237]

Finished a month of Trauma/Surgical ICU and I liked it a lot. You take care of the sickest patients in the hospital, are well-respected by colleagues, and you need to be very knowledgeable with just about everything. Downside are the hours and pay, but I might be able to deal with those.

Could someone please tell me which SICU meets all 4 criterias:

1. controlled by anesthesiology
2. closed units
3. well regarded
4. nice looking physical environment (no, not the nurses, but it is a bonus )

I'm just an MS IV but I would like to know. I think Pittsburgh and Columbia meet all these criterias (not sure about 4.). Thanks.

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[Idiopathic]

Florida has the largest anesthesia-run SICU in the country, according to their PD. 80+ beds, with ~100 planned for down the road.

Their CC program is well-regarded also, from what I have heard.

 

[chicamedica]

Pittsburgh sure doesn't meet 1 and 2 (unfortunately). But it is the birthplace of CCM through the guru Peter Safar, who if i'm not mistaken, was an anesthesiologist.

 

[xjohns1]

there are many, many surgical units or specialty surgical units (neuro, CT, etc) that are closed and run by anesthesia depts. from what i remember from the interview trail last year, u penn, columbia, cornell (doesn't have a cc fellowship), brigham and women's are just a few that control at least one surgical unit. what i found to be much more rare is anesthesia's providing medical direction in a medical icu. from what i can remember, mgh, johns hopkins, and (definitely) ucsf depts run medical units. ucsf's units, however, are semi-closed (and they'll tell you it's not a bad thing). i agree that pittsburgh has a vast and well regarded critical care program but it is a multidisiplinary unit that i believe is organized into a separate academic unit (i.e., the department of critical care). i guess i would name mgh, ucsf, johns hopkins, and u penn as departments very interested and active in the critical care aspect of anesthesia. at ucsf it is a major focus. i think your criterion #4 is silly.

Finished a month of Trauma/Surgical ICU and I liked it a lot. You take care of the sickest patients in the hospital, are well-respected by colleagues, and you need to be very knowledgeable with just about everything. Downside are the hours and pay, but I might be able to deal with those.

Could someone please tell me which SICU meets all 4 criterias:

1. controlled by anesthesiology
2. closed units
3. well regarded
4. nice looking physical environment (no, not the nurses, but it is a bonus )

I'm just an MS IV but I would like to know. I think Pittsburgh and Columbia meet all these criterias (not sure about 4.). Thanks.

 

[nitecap]

quit sweating me man.

 

[redstorm]

If you want to run a medical ICU... go into Internal medicine and do a critical care medicine fellowship.... CLosed units are bogus because if I am a surgeon who spent 5- 6 hours in the OR with the patient.. Im not about to let an anesthesiologist dictate the care the patient receives..

 

[Tenesma]

MGH has a closed (meaning anesthesia writes all the orders and makes all the calls) surgical/trauma ICU that is brand spanking new (4 years old - the old one was getting nasty). And the nurses are easy on the eyes... However, recently, due to lack of ICU training for MGH surgical residents we have started allowing surgical residents to rotate through so as to alleviate the call schedule (changed from q3 90-95 hours/week to q4 w/ 70 hours a week).

 

[jc237]

If you want to run a medical ICU... go into Internal medicine and do a critical care medicine fellowship.... CLosed units are bogus because if I am a surgeon who spent 5- 6 hours in the OR with the patient.. Im not about to let an anesthesiologist dictate the care the patient receives..

Sure, it is advantageous for the CC anesthesiologist to listen to what the surgeons have to say about the care of the patient. A lot of times, they do allow the surgeons to have a say.... up to a point. And that's where the importance of a closed unit comes in. Many many surgeons just know how to cut, not to manage a very sick patient. If what the surgeon say is just wrong or recent data have disproved, I sure as heck is not gonna follow just b/c the surgeon thinks it's "his" patient. Data has suggested that a closed unit has better patient outcomes than an open unit.

 

[jc237]

i think your criterion #4 is silly.

No, not silly. If you have to pick between an ICU that looks like the dumps and an ICU that is new, or just renovated and has the newest equipment, where would you want to work, if everything else being equal? Just b/c we're going to be doctors, or are doctors, that doesn't mean that we shouldn't care about such important things as aesthetics. Again, having nurses that are easy on the eyes IS a bonus. They need to balance out my brutal ugliness and therefore make the place harmonious .

 

[jc237]

 

[Mman]

No, not silly. If you have to pick between an ICU that looks like the dumps and an ICU that is new, or just renovated and has the newest equipment, where would you want to work, if everything else being equal? Just b/c we're going to be doctors, or are doctors, that doesn't mean that we shouldn't care about such important things as aesthetics. Again, having nurses that are easy on the eyes IS a bonus. They need to balance out my brutal ugliness and therefore make the place harmonious .

I think the point is how much time will you even see those nice digs as an anesthesia resident? Figure only 36 months as an anesthesia resident and maybe 3-6 months at most in that attractive unit? Your eyes will be on the OR surroundings a heck of a lot more than they will the ICU which is why most people would worry a heck of a lot more about the quality of the ICU training than what the ICU looks like because you will see very little of it.

Now if you're talking about a fellowship in critical care, then it would matter a touch more.

 

[Tenesma]

redstorm... it doesn't matter how long the surgeon operates on the patient... Do you think an orthopedic surgeon, who just did a pelvic and femoral ex-fix on a trauma patient, should have a say in a patient's critical care?
Do you think a general surgeon, who just did a splenectomy and packed a liver for a trauma patient, should have a say on how we manage the ICP....

For the most part - in the real world - most, if not all, surgeons are very happy that somebody is in the ICU ready to take care of all the issues. Is the surgeon involved with surgical decision making in the ICU - of course...

the surgical ICU is a world away from the medicine ICU... for the most part in the medicine ICU you have 1) pneumonias 2) septicemia....
the surgical ICU takes the medical ICU patient and then adds ten layers of complexity. I personally thought i was the **** after doing 4 months of medical ICU during internship.... boy did i get spanked in the surgical ICU... a whole new ball game

 

[sean wilson]

Could you elaborate on the extra layers of complexity seen in the SICU?

 

[Gator05]

Could you elaborate on the extra layers of complexity seen in the SICU?

Well, the medical issues never went away, and now they have surgical issues. And the surgical issues makes the medical issues worse. Big circle.