Cardiothoracic Critical Care is a growing subspecialty of critical care medicine that involves the treatment of patients with cardiothoracic pathology. This population includes post-cardiotomy, cardiogenic shock, respiratory failure, pre- and post-thoracic transplant, VAD implantation, and patients requiring temporary mechanical circulatory support (ECMO, Impella, intra-aortic balloon pump). Effectively caring for these high-acuity patients requires advanced training in the knowledge base, technology, and procedural skills that encompass this increasingly nuanced and complex field. As a leading cardiovascular center with a history of providing cutting-edge cardiothoracic critical care, we are uniquely well-positioned to meet the growing demand for this level of training.
This one-year non-ACGME fellowship provides an immersive training experience to board-certified and board-eligible intensivists dedicated to practicing and leading as cardiothoracic intensivists. Trainees will be immersed in our high-volume, high-acuity CTICU and gain the exposure, knowledge, and technical skills necessary to care for patients with advanced cardiothoracic diseases.
Given the multidisciplinary nature of our department and prospective trainees, the fellowship is designed to identify the strengths and gaps in experience of each fellow and tailor the clinical and educational experience to meet their specific needs. Fellows will benefit from a rigorous and broad clinical experience, expert instruction and mentorship, focused electives, and a range of research, educational, safety, and quality initiatives.
- Mission Statement
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The Advanced Cardiothoracic Critical Care and ECMO Fellowship at UPMC is committed to providing superior clinical and academic training that delivers the highest quality care to critically ill and injured patients across the UPMC Health System, and that develops tomorrow’s leaders in Cardiothoracic Critical Care. Our multidisciplinary and collaborative approach to research, education, patient safety, and quality is integral to this training and enhances the program’s ability to improve and innovate in each of these areas. We seek to select and retain a diverse group of highly qualified candidates and foster their academic career advancement through broad clinical experience, scholarship, leadership opportunities, structured professional development, and robust mentorship.
- Eligibility and Application
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To be eligible to apply for the Fellowship, physicians must be board-certified or board-eligible in critical care medicine. All clinical backgrounds are welcome to apply, including internal medicine, emergency medicine, anesthesiology, surgery, and neurology.
Interested applicants should email a letter of interest (one page) and curriculum vitae to Trisha Field. Candidates being considered will have the opportunity to meet and interview with the program director, departmental and CTICU leadership, and non-critical care physicians from collaborating disciplines.
Applications will be considered and selections made on a rolling basis.
- Clinical Experience
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Fellows will spend several months in our 28-bed cardiothoracic intensive care unit (CTICU), working to acquire in-depth knowledge of the unique pathology, management, and technology involved in the care for our patients.
This clinical time consists of:
~22 weeks of daytime rounding includes:
- Graduated autonomy in rounding and patient management
- ECMO consults, multidisciplinary cardiogenic shock team calls
- Direct supervision of residents and fellows
~36 night shifts include:
- Independent management of CTICU patients overnight
- Admission and management of new patients and late surgical cases
- Coverage for ECMO consults, cardiogenic shock team calls, interhospital transfers
- Nighttime ECMO support, including cannulation, troubleshooting, ECPR
- CTICU attending support from home (will come in for any acute management and procedural issues)
Trainees obtain hands-on clinical experience and advanced instruction in:
- Effective communication and care coordination between multiple care teams in a multidisciplinary setting (critical care, cardiothoracic surgery, transplant surgery, heart failure cardiology, transplant pulmonology, anesthesiology)
- Pathophysiology and management of pre-and postoperative cardiac surgery patients (coronary, valvular, structural, and aortic diseases)
- Pathophysiology and management of cardiogenic shock
- Pathophysiology and management of refractory respiratory failure Indications, candidate selection, and management of mechanical circulatory support (Impella, balloon pump, ECMO, VAD)
- Comprehensive ECMO training, including:
- Current technology and circuit anatomy
- Indications and candidate selection (cardiac and respiratory failure)
- Cannulation and configuration
- Physiology
- Daily management
- Complications and troubleshooting
- Weaning and decannulation
- CTICU Highlights
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- 28-bed unit
- 1300-1500 cardiac surgery cases/year
- 120-130 ECMO cases/year
- ~75 VA ECMO cases/year
- ~50 VV ECMO cases/year
- ~70 Impella 5.5 cases/year
- 35-45 heart transplants/year
- 60-80 lung transplants/year
- ~30 VAD implantations/year
- Contact
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For inquiries about the Advanced Cardiothoracic Critical Care and ECMO Fellowship Program please contact Trisha Field, Program Coordinator and GME Sr. Department Manager.
Program Director - Timothy B Kaselitz, MD, MPH
- Social Media
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Department of Critical Care Medicine at Pitt (@ccmpittofficial) • Instagram photos and videos
Pittsburgh CCM Fellowship (@pittsburghccm) • Instagram photos and videos
https://twitter.com/PCCMPittsburgh
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