I'm an anesthesiology resident at UPMC, and will have to get back to you on specifics of the CCM Fellowship (which I am very strongly considering) after I do my first CCM rotation in September, if anyone is interested
From the grapevine, it is indeed a rigorous year (or years). SOME of the ICUs have residents working underneath fellows, but several units do not have residents. You rotate among several hospitals, and that will (obviously) influence your caseload and clinical severity. From what I've seen doing anesthesiology-related work (pt preops, transport to ICU, ICU rotations as an intern), almost any rotation at UPMC Presbyterian/Montefiore (two formerly separate hospitals now connected by a bridge to form a monster hospital) will be pretty intense - especially Trauma ICU. It almost seems as if you can name a clinical entity, UPMC will put "ICU" after it, and then it's a unit. There's a Neurotrauma ICU, Neurovascular ICU, SICU x 2, MICU x 2, CTICU x 2, Transplant ICU...that may be it. Seems like there could be more, maybe. I just counted the ICU pt list - I don't know how many beds total there are, but as of right this moment, we have 137 patients in ICU beds in Presby/Monte. Neuro does some cooling stuff, the SICUs do a ton of ECMO, CTICU takes care of s/p transplants, hearts, VADs, IABPs etc. Transplant ICU has everything - liver, kidney, small bowel, multivisceral, and hand. We were approved for face, but I've not heard anything about that. My understanding is no residents in CTICU or Transplant ICU. Magee, the Women's Hospital, is (was?) small and relatively quiet, but it's being expanded as we speak, and there is almost always at least one pregnant pt with some sort of lung pathology that we debate c-sectioning in the ICU so that the mom can be placed in a prone bed. They are also increasing thoracic and bariatric surgery volume there, and there's always that chance of amniotic fluid embolism with any of the pregnant ladies. VA Hospital ICUs may be (predictably) slower, but can go crazy quickly. I did my two intern year ICU months there, and we, as interns, worked under Pulm/CC fellows - which is different from the CCM Department fellows. CCM Department fellows staffed the Surgical ICUs without residents beneath them. Pittsburgh is one of two VA Hospitals that do liver transplants; we're the east of the Mississippi one, so you can see your share of disasters from that aspect. I believe CCM Dept fellows will also go to Shadyside, which has much of our big whack cancer surgery cases, very busy heart/aorta/thoracic surgery service, and medical cancer treatment. Not too familiar with stuff there, but there's at least a CTICU, MICU, and SICU. I'm under the impression that you get a resident in MICU and SICU there, but don't quote me.
I have not heard about drop-outs per se, but hell, who would tell me? Additionally, the anesthesiology-trained CCM fellows do only one year, and have something like 3 or 4 months out of the ICUs for elective/vacation. Rumor is that some months can have very tight scheduling for fellows, but the Department is trying to help - we (anesthesiology residents) were just offered the chance to do ICU Moonlighting shifts to help ease fellow call burden, and they may be trying to hire mid-level providers for some additional assistance.
Residents senior to me have been interviewing for anethesiology based CCM fellowships elsewhere, but almost to a man, each has said the experience at UPMC is better than any other place they've interviewed. Should you be so inclined, it doesn't look like they are hurting at all for research opportunities, either.
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