Critical Care Medicine
Memorial Sloan Kettering was one of the first hospitals to have an Intensive Care Unit (ICU) dedicated to the care of cancer patients with severe illnesses. For more than 40 years, the Critical Care Medicine (CCM) Service has provided state-of-the-art care to critically ill and postoperative patients both in the ICU and on inpatient floors via our consultation service. We are committed to the education of fellows and residents as one of our core principles. Recently, we developed an innovative, nurse practitioner–led ICU team that has grown from providing care in our ICU to pioneering our highly effective rapid response team, which attends to those in the hospital needing urgent care.
Our 20-bed ICU was built to take advantage of the innovative principles of ICU design. From the ergonomic floor construction to the electronic windows and equipment booms, the ICU promotes a healing environment, efficient workflow, and ease of patient care.
The ICU is furnished with all the tools necessary to provide the excellent care that is the standard at MSK. Our state-of-the-art equipment includes adult and pediatric bronchoscopes, point-of-care ultrasound machines, various minimally invasive hemodynamic monitors, transvenous pacing equipment, an abdominal pressure monitoring system, a bladder scanner, a therapeutic hypothermia device, and fluid warmers. Coming in 2015 is point-of-care laboratory testing both in the ICU and as part of the rapid response service.
Our faculty, fellows, nurse practitioners, physician assistants, and residents provide care daily to patients in the ICU and throughout the center. Two teams of clinicians care for patients admitted to the ICU (a traditional housestaff team and an advanced practitioner team); a third team (consult/RRT team) consults for acutely ill patients on the wards and provides rapid response for any individual at the center with an acute health issue. These services are very active. In 2013 CCM took care of approximately 1,000 ICU admissions, 1,400 ICU consults, and 900 rapid response calls.
One mark of the increasing role of the CCM throughout the building is our rapid growth. The number of full-time faculty has increased from three in 2003 to six in 2013. Additionally, we have two anesthesiologist-intensivists that participate in ICU coverage. Over the same period, our fellowship program has grown from six to ten fellows. Our high-level nurse practitioner group in the ICU has grown from 11 nurse practitioners in 2006 to 25 today.
Multidisciplinary care is a cornerstone of our mission. Our daily rounds include the bedside nursing staff, a critical care pharmacist, a nutritionist, a social worker, and a respiratory therapist. Social work services are available throughout the evening hours in order to accommodate evening family visitation. Once a week, multidisciplinary rounds take place that focus on ensuring good communication between clinicians, nurses, infection control, social workers, patient representatives, and chaplains.
The education of our fellows, nurse practitioners, physician assistants, residents, and medical students is a vital aspect of our service. It is crucial for the growth of our specialty that we train the finest intensivists in our field.
Our fellowship training program follows a detailed educational curriculum that incorporates a core lecture series, visiting professor conference, fellows’ grand rounds, ventilator and bedside ultrasound workshops, simulation training, and weekly case review and morbidity and mortality conferences. Fellows are encouraged to participate in research, present at local and national conferences, and contribute to patient safety and quality improvement projects.
The fellowship program has consistently delivered an extremely high pass rate (100 percent over the last five years) for fellows taking the ABIM Critical Care Medicine Certification examination. Our two-year internal medicine-CCM and internal medicine subspecialty-trained fellows have secured intensivist and pulmonary critical care jobs in teaching hospitals throughout the country. Several pulmonary-CCM—trained graduates have proceeded to pursue additional fellowships in sleep medicine, interventional pulmonology, and pulmonary hypertension at prestigious medical centers including the Cleveland Clinic, Johns Hopkins, and Beth Israel Deaconess Medical Center. A few have become ICU directors or associate program directors of the residency or fellowship programs at their institutions.
The Critical Care Medicine service conducts industry-funded clinical trials in severe sepsis/septic shock, pneumonia, and acute respiratory distress syndrome; collaborative studies with national and international critical care study networks; and “homegrown” projects such as outcome studies of chemotherapy and ethics consultations in an oncologic ICU and patterns of intrahospital transport and ICU readmissions.
The Critical Care Medicine Service welcomes applicants trained in internal medicine, medical subspecialties (i.e., pulmonary, renal, and infectious disease) and emergency medicine or emergency medicine/internal medicine. We appreciate your interest in our program and encourage you to apply to become part of our team. Our faculty is dedicated to teaching and providing advanced subspecialty training. Our trainees are highly qualified candidates who come from across the United States for this unique learning experience.
1 or 2 years
Apply at least 1 to 1 ½ years prior to the expected start of the fellowship. An application form can be downloaded here.
Fax Number: 212-794-4333