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Curriculum

Learn about the curriculum of the Critical Care Medicine: Anesthesiology Fellowship at Dartmouth-Hitchcock Medical Center in Lebanon, NH.

Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Mechanical ventilation indications, techniques and complications

  • Didactic lectures
    • Lung recruitment and derecruitment in ARDS
    • Nitric oxide in the cardiac surgical patient
    • Physiological determinants of patient-venilator interactions
    • Ventilator modes
  • Journal club conferences: Multiple conferences
  • Bedside teaching
  • Textbooks

Assessment and evaluation of pulmonary function

  • Bedside teaching
  • Didactic lectures
    • Respiratory mechanics
    • Topics in gas exchange
  • Pulmonary elective

Basic and advanced cardiopulmonary resuscitation

  • Fellows must be certified in ACLS prior to completion of their training. DHMC education department provides training program.
  • ATLS certification is advised.

Pharmacologic and mechanical support of circulation

  • Bedside teaching
  • Didactic lectures
    • Surgical critical care
    • Hypertensive emergencies
    • Critical care obstetrics
    • Critical care of the postoperative cardiac surgical patient
    • Trauma
    • Perioperative Issues
  • Journal club conferences: multiple conferences

Evaluation and management of central nervous system dysfunction, including closed head injury and intracranial pressure monitoring

  • Bedside teaching
  • Didactic lectures
    • Subarachnoid hemorrhage
    • BIS monitoring in critical care
    • Spinal cord Injury
    • Pain/sedation & neuromuscular blockade

Recognition and treatment of hepatic and renal dysfunction

  • Bedside teaching
  • Didactic lectures
    • Heatstroke - diagnosis and treatment
    • Renal replacement therapies
    • Electrolyte disorders
  • Textbooks

Diagnosis and treatment of sepsis

  • Didactic lectures: Multiple lectures
    • Randomized trials of anticoagulation factors for sepsis
    • Update on gram positive infection
    • Quixotic sepsis
    • ARDS - long-term outcome
    • Peritonitis
    • Glucose control and insulin therapy on critical illness
    • Sepsis/resuscitation practice guidelines
  • Bedside teaching
  • Case conferences: multiple
  • Journal club conferences: multiple

Fluid resuscitation and management of massive blood loss, management of hemostatic defects

  • Didactic lectures
    • Red blood cell transfusion practices
    • Treatment of platelet disorders
    • Massive transfusion
  • Bedside teaching

Monitoring and assessment of metabolism and nutrition

  • Ongoing bedside teaching
  • Nutrition elective
  • Textbooks

Psychiatric effects of critical illness

  • Didactic lectures
  • Ongoing patient care
  • Palliative care elective

Medical Knowledge

Fellows must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Airway maintenance and management

  • Didactic lectures
    • Devices for single lung ventilation
    • Topics in advance airway management
    • Emergency airway mangement
  • ACLS
  • Bedside procedural teaching
  • Anesthesiology Instruction
    • Anesthesiology rotation
    • Anesthesiology airway course
  • Procedure documentation

Devices which supply supplemental oxygen including use of reservoir masks and continuous positive airway pressure masks, humidifiers, nebulizers, and incentive spirometry

  • Bedside teaching
  • Journal club conferences: Multiple conferences

Indications of and techniques for emergency and therapeutic treatment of conditions requiring thoracentesis and/or tube thoracotomy

  • Bedside teaching
  • ATLS (recommended)
  • Procedure documentation
  • Textbooks, ongoing literature review

Emergency and therapeutic fiber optic laryngotracheobronchoscopy

  • Bedside teaching
  • Pulmonary elective

Maintenance of circulation, arterial puncture, blood sampling, insertion of central venous, arterial and pulmonary artery balloon flotation catheters

  • Didactic lectures
    • Appropriate Use of Pulmonary Artery Catheters
    • Central Venous Catheter Infections
  • Online modules (Pulmonary artery education project, link found on http://an.hitchcock.org/icu/educationovervie.html)

Contraindications, complications, limitation of, and procedures for pericardiocentesis, transvenous pacemaker insertion, peritoneal dialysis, peritoneal lavage, insertion of chest tubes, percutaneous needle aspiration

  • Bedside teaching
  • Procedure tracking

Interpretation of antibiotic levels and sensitivities

  • Bedside teaching
  • Textbooks

Bioengineering and monitoring, amplifiers and recorders

  • Didactic lectures
    • Monitoring Physics

Interpretation of laboratory results

  • Bedside teaching

Transesophageal echocardiography (TEE)

  • TEE conference
  • Echocardiography elective

Practice-Based Learning and Improvement

Fellows must be able to investigate, evaluate and improve their patient care practices, and appraise and assimilate scientific evidence.

  • Administrative aspects of critical care
    • Didactic lecture
      • Administrative aspects
      • General orientation
    • ICU administrative management of triage responsibilities
    • Bedside rounds

Communication Skills

Fellows must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients' families, and professional associates.

  • Didactic conferences: Graduate Medical Education series
  • Ongoing bedside teaching and feedback
  • Bedside rounds
  • Palliative care elective

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

  • Ethical and professional aspects of critical care
    • Didactic lectures
    • Ongoing patient care/ethics committee consultations
    • Ongoing direction of care family conferences

Systems-Based Practice

Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal care.

  • Quality assurance systems development
    • Didactic lectures
    • Committee involvement
  • Quality assurance projects
  • Research design
    • Journal club conferences: Multiple conferences
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