ICU rotations at YOUR surgery residency?

[europeman]

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Any peeps at the larger, academic programs willing to share how many ICU rotations (how many months and what year) they do?

 

[Winged Scapula]

Do you mean strictly ICU? We had an open ICU which means that we did ICU time on almost every rotation/every year as we managed our trauma/HPB/Txp/Vascular/Pedi pts ourselves (albeit with some variable input from the SICU/PICU teams).

But it was generally:

PGY-1: 1-2 months
PGY-2: 2 months
PGY-3: Burns 1 month
PGY-4: 1 month
PGY-5: none

 

[balaguru]

The ICU experience at our program varies among residents and classes. Burns nearly always has a few 1st years, a 2nd year and a 4th year. Currently, the SICU has a few 1st years, a fellow and some combination of 2nd years, 3rd years and 4th years. The 4th years complained that they didn't get enough SICU experience so were added to the schedule.

Here was my experience:
pgy1: burns x 1mo
pgy2: burns x 1mo + sicu x 2mos
pgy3: sicu x 1 mo
pgy4: burns x 1mo
pgy5: none

Any peeps at the larger, academic programs willing to share how many ICU rotations (how many months and what year) they do?

 

[europeman]

winged scapula... where did you train?


anyone else? and where was or IS your training?

 

[LucidSplash]

I'm at a communiversity program in the southeast, not a large academic center. However, for those interested: we have a mixed ICU. The surgical critical care service cares for all trauma ICU admits in any of our 7 ICUs. Other surgical services have the option of consulting the SCC team when putting a patient in the unit or continuing as primary themselves. We rotate through on the SCC service for a total of 5-6 months as PGY2s and 3s. Obviously we also care for non-trauma ICU patients at other levels up through PGY6 (we are a 6-year program) as primary if SCC is not consulted.

 

[Winged Scapula]

winged scapula... where did you train?

It's in my profile.

anyone else? and where was or IS your training?

Look most people on here are not going to reveal to you exactly where they are training. I also fail to see how that might be relevant but you have to respect people's privacy.

 

[deleted50541]

Interns are pretty tied to the floors, so they don't have much exposure to the ICU. Otherwise, we take care of the ICU nearly every rotation thereafter.

The basis of our critical care training comes from 3-4 months dedicated to the trauma/surgical ICU in PGY-2. It's a closed unit and a major milestone as the first significant experience we get with regards to independent decision making. The seniors on trauma are always there as backup overnight, but any resident worth their salt learns to handle most situations on their own.

After that, ICU patients fall under the care of the PGY-2s,3s, and 4s depending on the hospital. We do have dedicated SICU attendings at two sites (a fairly new occurrence), but they usually aren't in house overnight and the nurses are used to calling up the resident anyway.

As for burns, we cover it as part of our 6 months on trauma as PGY-3s. Keeps us busy.

 

[deleted89854]

At our place:

PGY1: 4 weeks SICU + 4 weeks burns
PGY2: 5 weeks TICU + 10 weeks private hospital ICU
PGY3: 2 months SICU + 2 months burns

All units are open, so PGY 4s and 5s are on call for their ICU patients with the resident in house covering/rounding.

 

[Winged Scapula]

At our place:

PGY1: 4 weeks SICU + 4 weeks burns
PGY2: 5 weeks TICU + 10 weeks private hospital ICU
PGY3: 2 months SICU + 2 months burns

All units are open, so PGY 4s and 5s are on call for their ICU patients with the resident in house covering/rounding.

Damn that's a lot of dedicated ICU and burns time!

 

[filter07]

3 months ICU as PGY2
Rest of the time in various services managing patients in an open ICU

 

[balaguru]

At our place:

PGY1: 4 weeks SICU + 4 weeks burns
PGY2: 5 weeks TICU + 10 weeks private hospital ICU
PGY3: 2 months SICU + 2 months burns

All units are open, so PGY 4s and 5s are on call for their ICU patients with the resident in house covering/rounding.

Yikes! Are you covering cases during all this icu time?

 

[BlondeDocteur]

UW is *extremely* critical care-heavy. I liked it. And for all of these months, almost exclusively, you're in the Unit only, no OR time.

PGY-1: 1-2 months SICU, either at the VA, the University hospital, or both; 1 month Burns
PGY-2: 2 months TICU at the trauma hospital; 2 months Cardiothoracic Surgical ICU at the University hospital; 1 month SICU at university hospital; 1 month SICU at the VA [also an anesthesia rotation]
PGY3: 1 month as chief resident on the Burn service
PGY-4&5: no dedicated time

 

[thedrjojo]

SICU is closed at the main teaching hospital, and residents are dedicated there without operating. At the private hospital, SICU is open so we manage our ICU patients, and at the VA there is no dedicated ICU rotation/team, its just managed by the surgical team. CTICU is run by the CT surgery team:

Intern year: In flux, pre 16hr work day 1 month dedicated SICU rotation... this year they eliminated interns in the unit, but next year we are fighting to get it back... 1 month CT surgery intern with some ICU management required
PGY2: 6 weeks dedicated SICU, 6 weeks as midlevel at VA solo in the ICU overnight
PGY3: 6 weeks dedicated SICU, 6 weeks as midlevel at VA solo in the ICU overnight, 6 weeks as CT chief with major ICU management required

PGY4 and 5, no dedicated ICU time, but we are involved in managing our teams pts in the ICU's in conjunction with ICU teams, plus oversee the VA ICU.

 

[S4surgery]

Large University at south Texas
PGY1= 1 month SICU, 1 Month TICU
PGY2= 1 month VA SICU, 1 Month TICU
PGY 3= 7 weeks X 3 SICU chief, yes 21 weeks (burns are within SICU)

 

[Miami_med]

PGY1- 1 month SICU
PGY2- 4 months SICU
PGY2-3- 4 months of night ICU coverage.

 

[45408]

SICU - one month as an intern, one month as a PGY-2
burn unit - one month as a PGY-2

Very frequent overnight coverage of the SICU, but nothing too bad. And you always still cover your own patients when they go to the unit post-op.

 

[Dirt]

PGY 1 - 1 month
PGY 2 - 2-3 months
PGY 3 - 1 month

Closed unit. Combined SICU, N-surg, trauma.

We also get anesthesia CA-2s, and ED PGY 2s in the unit with us, with a surgical resident as chief of the service, and have a night float system with residents taking 1 week of nights during their SICU months.

 

[illixir]

We have a closed unit but still follow our patients and make most of the plans when on surgery teams. Dedicated time is 2 months as an intern and 1 month as a second year, another month in 2nd year for burns but we might be doing away with this(we rotate out for it).

 

[Dan Plainview]

Closed surgical/trauma ICU

PGY-1: 1 month
PGY-2: 3 months

And that's it. As the 2, there is usually not a fellow between you and the consultant, so you're sort of forced to "grow up" quickly.

 

[mimelim]

PGY1 - 0m
PGY2 - 2m SICU day, 1m SICU night, 1m CVICU
PGY3 - 2m CVICU
PGY4 - 0m
PGY5 - 0m

SICU, no intensivist at night, CVICU, always an intensivist in house.

 

[deleted89854]

Yikes! Are you covering cases during all this icu time?

For the most part, no cases during the unit time, except for the occasional bedside laparotomy/thoractomy/tracheostomy in the TICU. The burn rotation actually involves a lot of trips to the OR for assorted grafts and whatnot. I think I did maybe 40-50 skin grafts during those 2 months. The private hospital ICU rotations are pretty new so I can't really comment on those.

 

[Surgnomad]

University Hospital in Southeast

PGY1-1 month Surgery and Trauma ICU
PGY2-2 months Cardiothoracic ICU, 2 month VA CT c mostly all ICU pt, 2 months backing up night STICU intern
PGY3-2 months STICU chief c CC fellow,
PGY4&5-no dedicated time but night backup if needed

-a few cases here and there on those rotations but not daily
-only a few peds burns here and there
-when on VA gen surg, Transplant, or Vascular we take care of our own patients in ICU otherwise we are consult and watch the Anesthesia/Pulmonary/Pediatrics critical care docs like a hawk...they always find some way to kill our patients 🙂